帕金森病患者脑内葡萄糖代谢特点的18F—FDG PET研究

Characteristics of cerebral glucose metabolism on 18F-FDG PET imaging in patients with Parkinson＇s disease

目的验证PD患者脑葡萄糖代谢特点在不同显像条件下的可重复性，为开展多中心研究奠定基础。 方法回顾性分析复旦大学附属华山医院33例PD患者（男15例、女18例，年龄38～79岁）和33名健康对照者（男15名、女18名，年龄40～77岁），以及中山大学附属第一医院17例PD患者（男10例、女7例，年龄44～74岁）和17名健康对照者（男6名、女11名，年龄42～67岁）静息状态下18F－FDG PET显像的数据。应用SPM软件分别对2家医院PD患者和健康对照者的PET图像行两样本t检验，用族错误率（FWE）校正P〈0.05为检验水平，获得差异具有统计学意义的像素点，最终获得2组PD患者葡萄糖代谢异常的脑区，并比较其变化特点的异同。 结果复旦大学附属华山医院PD患者与对照组相比，表现为小脑及脑桥、双侧苍白球和壳核、双侧丘脑、双侧感觉运动皮质葡萄糖代谢增高，累及范围8 110个像素；双侧枕叶、顶叶葡萄糖代谢减低，累及范围2 810个像素（P〈0.05）；中山大学附属第一医院PD患者与对照组相比，表现为小脑及脑桥、双侧苍白球和壳核、双侧丘脑葡萄糖代谢增高，累及范围15 573个像素；双侧枕叶、顶叶和双侧额叶葡萄糖代谢减低，累及范围3 945个像素（P〈0.05）。 结论2家医院的PD患者在不同的显像条件下均存在小脑及脑桥、双侧苍白球、丘脑葡萄糖代谢增高，双侧枕叶、顶叶葡萄糖代谢减低的表现，良好的可重复性为18F－FDG PET显像用于PD鉴别诊断的多中心研究奠定了基础。

Objective To validate the reproducibility of abnormal cerebral metabolic characteristics in PD patients from different medical centers using lSF-FDG PET imaging. Methods A total of 108 sub- jects who were referred for resting-state brain ISF-FDG PET imaging were retrospectively reviewed. Thirty- three PD patients （ 15 males, 18 females, age： 38-79 years） and 33 age-matched healthy controls （ 15 males, 18 females, age： 40-77 years） underwent evaluation at Shanghai Huashan Hospital Affiliated to Fu- dan University. Seventeen PD patients （10 males, 7 females, age： 44-74 years） and 17 age-matched healthy controls （6 males, 11 females, age： 42-67 years） underwent evaluation at the First Affiliated Hos- pital of Sun Yat-sen University. SPM was used to investigate the cerebral metabolic characteristics of the pa- tients with two-sample t test. Statistically significant voxels were obtained by using familywise error rate （FWE; P〈0.05）. Two sets of PD patients with abnormal glucose metabolism of brain regions were obtained and the cerebral metabolic characteristics were compared. Results Regarding the PD patients from Shang- hai Huashan Hospital, the features of cerebral glucose metabolism by SPM analysis were demonstrated as follows ： increased metabolism was found in the region of pons, cerebellum, thalamus, putamen and palli- dum, while decreased metabolism was displayed in the region of parietal lobe and occipital lobe. The in-creased regions referred to 8 110 voxels and decreased regions referred to 2 810 voxels （P〈O.05）. The simi- lar metabolic pattern was found in PD patients from the First Affiliated Hospital of Sun Yat-sen University. The increased metabolism was shown in the regions of pons, cerebellum, thalamus, putamen and pallidum, and referred to 15 573 voxels. The metabolism-decreased regions included parietal lobe, occipital lobe and frontal lobe, and referred to 3 945 voxels （P〈0.05）. Conclusions 18SF-FDG PET/CT imaging results dem- onstrate similar metabolic pattern in PD patients from different medical centers, in whom the metabolism-in- creased regions are found in the pons, cerebellum, thalamus and pallidum and decreased regions were dem- onstrated in the parietal lobe and occipital lobe. The reproducibility from ISF-FDG PET/CT imaging provides reliable evidence for the multi-center study in the differential diagnosis of PD.