^(18)F-脱氧葡萄糖单光子发射计算机断层显像鉴别阿尔茨海默病及额颞叶痴呆的临床研究

Application of ^(18)F-deoxyglucose in differential diagnosis of Alzheimer's disease and frontotemporal dementia by single photon emission CT

目的探讨阿尔茨海默病(Alzheimers disease,AD)及额颞叶痴呆(Frontotemporal dementia,FTD)患者18 F-脱氧葡萄糖(18F-deoxyglucose,18F-FDG)单光子发射计算机断层显像(SPECT)的特点。方法选择2014年12月~2015年10月在首都医科大学宣武医院核医学科就诊并诊断为AD和FTD的患者29例,按诊断分为AD组19例,其中男性8例,女性11例,平均年龄(61.57±7.46)岁;FTD组10例,其中男性6例,女性4例,平均年龄(62.80±7.53)岁。同期选健康老年人9例为对照组,其中男性4例,女性5例,平均年龄(60.11±10.79)岁。所有研究对象行18F-FDG的SPECT检查。结果对照组双侧大脑皮质、丘脑和基底节区未见异常放射性浓聚、稀疏或缺损。AD组和FTD组患者与对照组相比,18F-FDG的SPECT检查均表现为皮质代谢减低。AD组15例双侧大脑皮质对称性减低,其中40.00%顶、颞叶皮质代谢对称性明显减低;33.3%双侧顶叶皮质代谢对称性明显减低;13.33%伴有双侧额叶皮质代谢对称性减低。FTD组8例对称性减低,其中50%双侧额叶皮质代谢对称性明显减低。Fisher确切概率法检验显示,AD组和FTD组患者的SPECT脑代谢表现具有显著统计学差异(P<0.05)。结论18F-FDG的SPECT能够为临床鉴别诊断AD和FTD提供客观的影像学依据。

Objective To study the application of ^18F-deoxyglucose （^18 F-FDG） in differential diagnosis of Alzheimer＇s disease （AD） and frontotemporal dementia （FTD） by single photon emission CT （SPECT）. Methods Nineteen AD patients （8 males and 11 females） aged 61.57±7.46 years served as an AD group,10 FTD patients （6 males and 4 females） aged 62.80±7.53 years served as a FTD group,and 9 healthy elderly subjects （4 males and 5 females） aged 60.11±10.79 years served as a control group in this study. Their 18 F-FDG metabolism was tested by SPECT. Results SPECT showed symmetrical hypometabolism of ^18F-FDG in bilateral cerebral cortex of 15 AD patients with 40.00% in parietal and temporal lobes,33.3% in bilateral parietal lobes,and 13.33% in bilateral frontal lobes, and symmetrical hypometabolism of ^18F-FDG in 8 FTD patients with 50% in bilateral frontal lobes. Fisher probability test showed that ^18F-FDG metabolism was significantly different in AD and FTD patients （P〈0.05）. Conclusion ^18F-FDG metabolism tested by SPECT can provide imaging evidence for the differential diagnosis of AD and FTD.