正电子发射计算机断层成像术显像对慢性意识障碍患者的脑部网络分析

Analyze of awareness networks in patients with chronic disorders of consciousness by positron emission computed tomography imaging

目的应用^(18)F-脱氧葡萄糖(^(18)F-FDG)PET显像分析慢性意识障碍患者脑部网络区域的葡萄糖标准摄取值(SUV)特点。方法采用^(18)F-FDG PET计算23例慢性意识障碍患者和10名正常人大脑外在和内在感知网络区域、双侧丘脑、脑干的SUV。通过两独立样本t检验观察慢性意识障碍患者与正常对照者各部位SUV是否有差异;应用两独立样本非参数检验观察无反应性觉醒综合征患者和最低意识障碍患者以上部位SUV所占正常值的百分比是否有差异。结果慢性意识障碍组患者大脑外在和内在感知网络区域、双侧丘脑、脑干SUV均低于正常对照组(均P<0.0001)。与最低意识状态组患者比较,无反应性觉醒综合征组患者外在和内在感知网络区域、双侧丘脑SUV占正常的百分比均明显降低(均P<0.05);两组患者脑干SUV占正常百分比差异无统计学意义(P=0.137)。结论慢性意识障碍患者的大脑外在和内在感知网络区域、双侧丘脑、脑干的SUV较正常人降低;无反应性觉醒综合征患者除脑干外其他部位SUV均低于最低意识状态患者。

Objective To analyze the glucose standardized uptake value（SUV） of awareness networks regions in patients with chronic disorders of consciousness by brain ^18F-fluoro-2-deoxy-D-glucose（^18F-FDG） PET imaging.Methods^18F-FDG PET were performed to calculate SUV of external and internal awareness networks,thalamus and brainstem in 23 patients with chronic disorders of consciousness and 10 normal people. The SUV of each region between patients with chronic disorders of consciousness and normal people by two independent sample t-test were compared. Non-parametric test was used to compare the rate of normal SUV of each region between patients with unresponsive wakefulness syndrome and patients in minimally conscious state. Results Compared with normal group,the SUV of external and internal awareness networks,thalamus and brainstem of chronic disorders group were significantly lower（ all P〈0. 0001）. Compared with minimally conscious state group,the rate of normal SUV of external and internal awareness networks,thalamus of unresponsive wakefulness syndrome group were significantly decreased（ all P〈0. 05）; while the difference of SUV of brainstem between the two groups was not reach statistical significance（ P = 0. 137）. Conclusions The SUV of external and internal awareness networks,thalamus and brainstem of patients with chronic disorders of consciousness are significantly lower than those of normal people in ^18F-FDG PET imaging. The SUV of patients with unresponsive wakefulness syndrome is significantly lower than that of patients in minimally conscious state except of brainstem.