慢性酒精相关性脑损害的^18F-FDG PET-CT影像学表现分析

Characteristics of chronic alcohol-related brain damage from 18F-FDG PET-CT findings

目的 通过比较不同饮酒习惯人群正电子发射断层显像(PET-CT)[以葡萄糖类似物氟脱氧葡萄糖(18F-FDG)为显像剂]影像学表现分析酒精相关性脑损害特点。 方法 选择郑州大学第一附属医院自2016年8月至2018年11月行18F-FDG PET-CT影像学检查且有过量饮酒史的男性患者为过量饮酒组,同时按照1∶4比例选取同期行该检查的无饮酒史者患者为无饮酒史组。分析2组患者18F-FDG PET-CT影像学特点,比较2组患者按年龄分层后CT序列异常改变率的特点,以及饮酒与CT序列、PET序列异常的关系。 结果 过量饮酒组共入组52例患者,无饮酒史组共入组200例。45~59岁年龄段患者中,过量饮酒组较无饮酒史组患者CT序列异常改变率明显增高,差异有统计学意义(P<0.05)。CT序列中,2组患者共33例出现异常,主要表现为脑萎缩、腔隙性脑梗死等;PET序列中,2组患者共62例出现异常,主要表现为双侧额顶叶代谢水平减低等。52例过量饮酒组患者中,CT序列异常者较CT序列正常者年龄增大、饮酒年限更长、总饮酒量更多,差异有统计学意义(P<0.05);PET序列异常者较PET序列正常者周饮酒量及总饮酒量更多、饮酒年限更长,差异有统计学意义(P<0.05)。 结论 过量饮酒是中年男性脑部结构损害发生的重要危险因素,可引起大脑额顶叶等部位葡萄糖代谢水平减低。

Objective To analyze the characteristics of alcohol-related brain damage according to 18F-fluorodeoxy-glucose (18F-FDG) position emission tomography-computer tomography (PET-CT). Methods Excessive alcohol consumption patients accepted 18F-FDG PET-CT in our hospital from August 2016 to November 2018 were chosen as excessive alcohol consumption group and non-drinking patients accepted 18F-FDG PET-CT in our hospital at the same time were chosen as non-drinking group according to 1:4 ratio. The 18F-FDG PET-CT imaging data were analyzed;the characteristics of abnormal changed rate of CT sequences after stratification by age and the relations of alcohol consumption with abnormal CT sequences and PET sequences were compared between the two groups. Results A total of 52 patients with excessive alcohol consumption and 200 non-drinking patients were chosen. Among patients aged 45-59 years, the abnormal changed rate of CT sequences in the excessive alcohol consumption group was significantly higher than that in the non-drinking group (P<0.05). In the CT sequences, 33 patients in the 2 groups presented abnormalities, mainly including cerebral atrophy and lacunar infarction. In the PET sequences, 62 patients in the two groups presented abnormalities, mainly manifesting as reduced metabolism level of bilateral frontal and parietal lobes. Among the 52 patients from excessive alcohol consumption group, those with abnormal CT sequences were older, had longer drinking history and had higher total drinking amount than those with normal CT sequences, and the differences were statistically significant (P<0.05). As compared with those in patients with normal PET sequences, those with abnormal PET sequences had higher weekly and total alcohol consumption, and longer drinking history, and the differences were statistically significant (P<0.05). Conclusion Excessive alcohol consumption is an important risk factor for structural damages in middle-aged men, which can cause a decrease of glucose metabolism level in the frontal and parietal lobes.