摘要
目的分析阿尔茨海默病(Alzheimer disease,AD)患者^(18)F-脱氧葡萄糖(fluorodeoxy glucose,FDG)正电子发射断层显像/计算机体层成像(positron emission tomography/computed tomography,PET/CT)脑显像的代谢改变亚型特点,并比较各亚型间临床表现的差异。方法收集于北京协和医院神经科诊断为很可能AD且β淀粉样蛋白显像为阳性的患者51例(AD组),10名健康体检者作为对照,收集两组受试者^(18)F-FDG PET/CT脑显像资料,结合视觉分析对AD组与健康对照组^(18)F-FDG PET/CT图像进行基于体素的定量分析,按主要^(18)F-FDG代谢减低脑区分布对AD组进行分型,分析各亚型间临床表现的差异。结果根据代谢减低最明显的部位,将AD组分为边缘系受累为主(A型)、顶颞叶外侧皮层及额叶皮层为主(B型)、后皮质为主(C型)及不对称单侧颞叶受累为主(D型)4种亚型。本组患者以A型组为多见〔共31例(61.0%)〕,均存在记忆功能下降,B型组更易出现执行功能下降〔4(100.0%)〕,C型组视空间障碍表现更为明显〔7(87.5%)〕,D型组患者语言障碍突出〔7(87.5%)〕,差异具统计学意义(均P<0.05)。结论AD患者中存在与临床表现相关的大脑葡萄糖代谢改变亚型。
Objective To investigate the subtypes of metabolic patterns of brain ^(18) F-fluorodeoxy glucose(FDG)positron emission tomography/computed tomography(PET/CT)imaging in patients with Alzheimer's disease(AD)and compare the differences in clinical manifestations among various metabolic subtypes.Methods Fifty-one patients diagnosed as propable AD with positive AβPET imagings and 10 healthy people were enrolled.^(18) F-FDG PET/CT brain imagings of all participants were collected and analyzed by both visual analysis and quantitative voxel-based analysis.AD patients were divided into different subtypes based on the predominantly involved cortical FDG hypometabolic zones.The differences in clinical manifestations among the various subtypes of metabolic pattern were also compared.Results Four subtypes of metabolic patterns of brain ^(18) F-FDG PET imaging in patients with AD were presented:Type A.Hypometabolic zones were predominantly involved in the limbic system;Type B.Lateral temporo-parietal cortex and partial frontal cortex predominantly involved,but medial temporal lobe was sparing;Type C.Predominant hypometabolism in the posterior cortex;and Type D.Asymmetrically predominant hypometabolism in the unilateral temporal lobe.Type A group was the most common in this study(31 cases,61.0%),and all patients had memory function decline.Type B group was characterized by more severe executive dysfunction(4 cases,100.0%),the visual spatial disorder was more obvious in type C group(7 cases,87.5%),and the language disorder was more prominent in type D group(7 cases,87.5%).The differences were statistically significant(P<0.05).Conclusions There were different glucose metabolic subtypes related to corresponding clinical manifestations in patients with AD.
作者
贾琛皓
梁梦琳
郭瑞杰
刘霖雯
袁晶
崔瑞雪
JIA Chenhao;LIANG Menglin;GUO Ruijie;LIU Linwen;YUAN Jing;CUI Ruixue(Department of Nuclear Medicine,Peking Union Medical College Hospital,Peking Union Medical College,Chinese Academy of Medical Sciences,Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine,Beijing 100730,China;Department of Neurology,Peking Union Medical College Hospital,Peking Union Medical College,Beijing 100730,China;不详)
出处
《中国神经免疫学和神经病学杂志》
CAS
北大核心
2022年第6期482-487,共6页
Chinese Journal of Neuroimmunology and Neurology
基金
中央高水平医院临床科研专项(编号:2022-PUMCH-B-070)
国家自然科学基金(编号81771874)
中国医学科学院医学与健康科技创新工程项目(编号2021-I2M-C&T-B-012
2021-I2M-1-025)。