老年脑葡萄糖代谢的^(18)F-FDG PET/CT统计参数图分析

Statistical parametric map analysis of ^(18)F-FDG PET/CT for cerebral glucose metabolism in the elderly

目的:运用统计参数图(statistical parametric mapping,SPM)方法分析老年脑的^(18)F-FDG PET/CT图像,探讨健康成年人的脑葡萄糖代谢在静息状态下随年龄变化的分布特征。方法:回顾性分析2015年1月至2020年9月在南京医科大学第一附属医院行PET/CT检查的768例健康受检者的临床资料,其中老年组400例、青年组368例。采用SPM软件对受检者在静息状态下的^(18)F-FDG PET/CT脑显像数据进行基于体素水平的图像分析。数据采用SPSS 26.0软件进行统计学分析。结果:老年组受检者的脑代谢以双侧皮层代谢减低为主且以右侧半球为著,代谢减低的脑区主要包括双侧前、后扣带回,海马旁回灰质和额叶额中回灰质等(P均<0.001)。代谢增高的脑区主要为双侧小脑前叶灰质、丘脑、枕叶枕中回灰质、顶叶中央旁小叶灰质等(P均<0.001)。结论:结合^(18)F-FDG PET/CT图像和SPM方法进行老年脑葡萄糖代谢分析,对早期阿尔茨海默病的发现及诊断具有重要意义,可为研究与年龄相关的神经退行性疾病的脑代谢差异提供依据。

Objective To analyze ^(18)F-FDG PET/CT images of aged brains with statistical parametric mapping(SPM)to investigate the age-related distribution of brain glucose metabolism in healthy adults at rest.Methods The clinical data of 768 healthy subjects who underwent PET/CT examination at the First Affiliated Hospital of Nanjing Medical University from January 2015 to September 2020 were analyzed retrospectively,including 400 cases enrolled into an elderly group and 368 ones into a young group.The voxel-based image analysis of ^(18)F-FDG PET/CT brain imaging data of the subjects at rest was performed using SPM software.The data were statistically analyzed using SPSS 26.0 software.Results SPM analysis showed that the cerebral metabolism of the elderly group was mainly characterized by decreased metabolism of the bilateral cortex,especially at the right hemisphere.The hypometabolic brain areas included the bilateral anterior and posterior cingulate gyrus,the parahippocampal grey matter and the grey matter of the middle frontal gyrus(P<0.001).The brain areas with increased metabolism were mainly the grey matter of the bilateral anterior cerebellar lobes,the thalamus,the grey matters of the occipital middle gyrus and paracentral lobule(P<0.001).Conclusion Combining ^(18)F-FDG PET/CT images with SPM methods for glucose metabolism analysis in the aged brain is of value for the detection and diagnosis of early Alzheimer's disease and provides a basis for studying differences in brain metabolism in age-related neurodegenerative diseases.