正电子发射断层显像和结构核磁对阿尔茨海默病的诊断价值

Value of brain ^(11)C-PIB PET MRI and structured MRI in diagnosis of AD

目的了解^(11)C标记的匹兹堡复合物B(^(11)C-PIB)正电子发射断层显像(PET)和结构MRI在阿尔茨海默病(AD)诊断中的重要性。方法选取2016年1月~2018年12月于我院神经内科门诊和住院行头颅^(11)C-PIB PET和头颅MRI检查患者33例,根据临床诊断分为AD组17例,轻度认知障碍(MCI)组16例,同期选取认知功能正常12例作为对照组。头颅MRI检查观察脑萎缩严重程度,以内侧颞叶萎缩(MTA)阳性表示,^(11)C-PIB PET检查以标准吸收比值(SUVR)≥1.4为^(11)C-PIB摄取阳性,表示脑内β淀粉样蛋白(Aβ)沉积阳性,比较各组MTA阳性和^(11)C-PIB摄取阳性率。结果对照组、MCI组、AD组SUVR和MTA评分分别为1.3±0.2和(2.2±1.2)分、1.7±0.5和(2.6±1.1)分、2.2±0.4和(3.4±0.7)分,与对照组比较,MCI组和AD组SUVR明显升高(P<0.05),AD组MTA评分较对照组和MCI组明显升高(P<0.05)。与对照组比较,MCI组和AD组MTA阳性率(68.8%和94.1%vs 50.0%)、^(11)C-PIB摄取阳性率(87.5%和100.0%vs 16.7%)明显升高(P<0.05),且AD组MTA阳性率和^(11)C-PIB摄取阳性率较MCI组进一步升高(P<0.05)。MCI组2例^(11)C-PIB摄取阴性患者的MTA阳性;AD组1例患者MTA阴性。2种检查一致性较高。对照组50%患者MTA阳性但^(11)C-PIB摄取阴性。结论^(11)C-PIB PET和结构MRI对AD诊断有重要作用,Aβ沉积阴性不支持AD诊断。

Objective To study the value of ^(11)C-PIB PET MRI and structured MRI in diagnosis of AD.Methods Forty-five patients who visited the Outpapatent Department of Neurology or underwebt brain ^(11)C-PIB PET MRI and structured MRI in our center from January 2016 to December 2018 were devided into AD group(n=17),MCI group(n=16),control group(n=12).The severity of their encephala-trophy was assessed by brain ^(11)C-PIB PET MRI with medial temporal atrophy(MTA)considered as positive,standard absorption ratio of ^(11)C-PIB PET≥1.4 and intracranial Aβdeposition considered as positive ^(11)C-PIB PET MRI ^(11)C-PIB uptake.The positive ^(11)C-PIB uptake rates in different groups were compared.Results Control group,MCI group and AD group SUVR and MTA were respectively 1.3±0.2 and 2.2±1.2,1.7±0.5 and 2.6±1.1,2.2±0.4 and 3.4±0.7.The SUVR were significantly higher in MCI group and AD group than in control group(P<0.05),the MTA were significantly higher in AD group than in control group and MCI group(P<0.05).The positive rates of MTA and ^(11)C-PIB PET were significantly higher in MCI group and AD group than in control group(68.8%and 94.1%vs 50.0%,87.5%and 100.0%vs 16.7%,P<0.05)and in AD group than in MCI group(P<0.05).The MTA was positive in 2 negative ^(11)C-PIB uptake patients of MCI group and negative in 1 negative ^(11)C-PIB uptake patient of AD group.The consistency of ^(11)C-PIB PET MRI and structured MRI was rather high in diagnossi of AD.The MTA was positive while the ^(11)C-PIB was negative in 50%patients of control group.Conclution ^(11)C-PIB PET MRI and structured MRI play an important role in diagnossi of AD while negative Aβdeposition does not support the diagnosis of AD.