NF1患者大脑活动特征的PET-CT研究

PET-CT study of brain metabolism characteristics in patients with NF1

目的采用正电子发射断层扫描/X射线计算机断层成像(PET-CT)检测Ⅰ型神经纤维瘤病(NF1)成年患者大脑代谢活动特征变化情况,探讨该疾病稳定状态下的特异脑活动异常情况。方法利用PET-CT技术,结合脑内葡萄糖代谢特征分析方法,对自2018年1月至7月就诊于首都医科大学附属北京天坛医院神经外科的11例病情稳定的NF1患者(NF1组)和10例健康对照组进行全脑数据分析,运用基于Matlab的SPM软件比较NF1组与健康对照组在全脑水平上大脑各区域活动的变化。结果 NF1组与健康对照组在额叶、颞叶等区域存在不同的代谢特征。全脑分析结果显示NF1在右侧颞上回后部、中央区、额上回、额中回,双侧的颞叶内侧面、顶叶视觉区等脑区出现了与健康对照组不同的脑代谢表现,特别是在双侧丘脑区域出现了显著异常,差异具有统计学意义(P<0.05),主要表现为双侧丘脑区域的葡萄糖摄取减低,提示该区域的脑活动减弱。结论非中枢系统病变或疾病自身基因突变引起大脑的功能代谢变化,可能为NF1患者的一项重要临床特征,也将为该类疾病以及具有同类型脑部疾病患者的康复及治疗提供前瞻指导。

Objective To investigate the changes of brain activity characteristics in adult patients with neurofibromatosis type 1 (NF1) by using the positron emission tomography/X-ray computed tomography (PET-CT) combined with the analysis of glucose metabolism. Methods Eleven stable patients with NF1 and 10 healthy control groups were examined by PET-CT. The data were analyzed in whole brain, and the changes of activities in each region at the whole brain level of the 2 groups were compared by MATLAB software. Results The NF1 group and the healthy control group have different metabolic characteristics in the frontal lobe and temporal lobe. The results of whole brain analysis showed that NF1 showed a different brain metabolism compared with the healthy control group in the posterior part of the right superior temporal gyrus, the central region, the frontal gyrus, the frontal gyrus, and the bilateral temporal lobe and parietal visual area. Metabolic performance, especially in the bilateral thalamus area, showed significant abnormalities, the difference was statistically significant (P<0.05), mainly due to the decrease of glucose uptake in the bilateral thalamus region, suggesting that brain activity in this region was weakened. Conclusion Functional changes in patients with NF suggests that their non-central neural systemic diseases or gene mutations cause functional metabolic changes in the brain. This may be an important clinical feature of NF1, which will provide proactive guidance for the rehabilitation and treatment of such diseases and patients with the same type of brain disease.