皮质基底节变性患者脑部葡萄糖代谢特征分析

Characteristics of cerebral glucose metabolism in patients with corticobasal degeneration

目的利用18F-脱氧葡萄糖（FDG） PET对皮质基底节变性（CBD）患者脑部葡萄糖异常代谢特征进行分析。方法对2014年1月至2017年1月间10例临床确诊的CBD患者[男5例，女5例；平均年龄（63.4±6.2）岁]和20名年龄匹配的健康对照者[男8名，女12名；平均年龄（63.6±6.2）岁]的静息状态下18F-FDG PET图像进行基于体素的统计参数图（SPM）分析，获取CBD患者脑部葡萄糖异常代谢特征，并对2组受检者的局部脑葡萄糖代谢率（rCMRglc）进行对比。采用两样本t检验分析数据。结果SPM分析显示，与健康对照者相比，CBD患者受累严重肢体对侧的额叶（包括额上回、额中回、额下回、中央前回）、顶叶（包括顶上小叶、顶下小叶、角回、缘上回、楔前叶）、枕叶（枕中回）、颞叶（包括颞中回、颞下回、颞横回、梭状回）、岛叶和丘脑的葡萄糖代谢减低；而同侧的中央前回、中央后回、海马、岛叶、壳核，双侧小脑、旁中央小叶及脑桥的葡萄糖代谢相对增高。上述区域的rCMRglc在CBD组和对照组间差异均有统计学意义（t值：4.236～9.044，均P〈0.01）。结论基于18F-FDG PET显像获得的不对称性脑部异常葡萄糖代谢特征可有效鉴别CBD患者和健康对照者。

ObjectiveTo identify abnormal cerebral glucose metabolism characteristics in patients with corticobasal degeneration （CBD） using 18F-fluorodeoxyglucose （FDG） PET imaging.MethodsFrom January 2014 to January 2017, resting-state brain 18F-FDG PET imaging was performed in 10 CBD patients （5 males, 5 females; average age： （63.4±6.2） years） and 20 age-matched healthy subjects （8 males, 12 female; average age： （63.6±6.2） years）. Voxel-based statistical parametric mapping （SPM） was used to analyze images to obtain the CBD-related brain metabolic characteristics. The regional cerebral metabolic rate of glucose （rCMRglc） was compared between 2 groups by two-sample t test.ResultsCompared with healthy controls, CBD group demonstrated asymmetrically decreased glucose metabolism mainly in the cerebral hemisphere opposite to the more clinically affected body side, including the superior, middle and inferior frontal gyrus, the precentral gyrus, the superior and inferior parietal lobule, the angular gyrus, the supramarginal gyrus, the precuneus, the middle occipital gyrus, the middle and inferior temporal gyrus, Heschl gyrus, the fusiform gyrus, the insula and the thalamus. And relatively increased glucose metabolism was present in ipsilateral precentral and postcentral gyrus, hippocampus, insula and putamen, bilateral cerebellum, paracentral lobules and pontine. The rCMRglc in those regions was significantly different between CBD patients and healthy controls （t values： 4.236-9.044, all P〈0.01）.ConclusionThe asymmetric cerebral glucose metabolism features in CBD based on 18F-FDG PET imaging contribute to the differential diagnosis between CBD patients and healthy subjects.