18F-FDG用于评估外伤性嗅神经损伤对药物经鼻脑通路运输的影响

Using of 18F-FDG to evaluate the effect of traumatic olfactory nerve injury on drug delivery through the nasal-brain pathway: a PET-MRI pilot study

目的:通过嗅裂区滴注氟代脱氧葡萄糖(18F-FDG)评估外伤性嗅神经损伤对经鼻给药后药物经鼻脑通路运输的影响。方法:招募7例嗅觉功能正常志愿者(正常组)和5例外伤性嗅觉障碍患者(嗅觉障碍组),于鼻内镜下嗅裂区滴入18F-FDG,12 h后行PET/MRI扫描,分析2组之间嗅球直径、嗅球感兴趣区摄取量等参数的影响。结果:18F-FDG直接接触筛板与未直接接触筛板时嗅球感兴趣区摄取量在正常组(P=0.0127)和嗅觉障碍组(P=0.0381)中的差异均有统计学意义。正常组与嗅觉障碍组嗅裂内18F-FDG直接与筛板接触侧的嗅球摄取量无明显差异(P=0.9372)。结论:外伤性嗅觉障碍患者嗅球明显萎缩,嗅球感兴趣区对18F-FDG的摄取也随之降低,18F-FDG经嗅裂区给药可以通过鼻脑通路进入嗅球及嗅球旁组织,嗅神经元的离断损伤对18F-FDG经鼻脑通路进入中枢神经系统的影响并不明显。

Objective:This study evaluated the effect of traumatic olfactory nerve injury on drug delivery through the nasal-brain pathway via the instillation of 18F-FDG at the olfactory cleft.Method:Seven healthy volunteers and 5 patients with traumatic dysosmia were enrolled in the study.Subjects were all instilled with 18F-FDG on each side of the olfactory cleft under endoscopy.After 12 hours,a PET/MR scan was performed to track the metabolism pathway of 18F-FDG.Then,we compared the diameter of the olfactory bulb and the olfactory bulb intake between normal volunteers and patients with traumatic olfactory disorders.Result:In healthy volunteers,there was a significant difference in 18F-FDG uptake between the regions of interest in which 18F-FDG was or was not in contact with the cribriform plate(P=0.0127);this difference also existed in patients with traumatic olfactory disorders(P=0.0381).Patients with traumatic olfactory disorders did not exhibit significant differences in 18F-FDG uptake in the region of interest compared with healthy volunteers(P=0.9372).Conclusion:The olfactory bulb is obviously atrophied in patients with traumatic olfactory dysfunction,and the uptake of 18F-FDG in the olfactory bulb region of interest is also reduced.The administration of 18F-FDG via olfactory fissure area can enter olfactory bulb and parafrontal tissues through the nasal brain pathway,18F-FDG can enter the central nervous system through the nasal-brain pathway,which is not affected by olfactory nerve transection injury.