不同参考脑区下阿尔茨海默病患者^(18)F-AV45 β淀粉样蛋白PET显像的标准摄取值比值及诊断界值

Standard uptake value ratio and diagnostic threshold of ^(18)F-AV45 β-amyloid PET imaging in patients with Alzheimer′s disease under different reference regions

目的:研究分别以小脑灰质、小脑及脑桥作为参考脑区时阿尔茨海默病(AD)患者大脑皮质^(18)F-AV45 β淀粉样蛋白PET显像的标准摄取值比值(SUVR)及诊断界值。方法:选择2020年6月至2022年2月在郑州大学第一附属医院临床诊断为AD,并经^(18)F-AV45 PET显像视觉评估为β淀粉样蛋白阳性的AD患者20例,其中男4例,女16例,年龄(60.8±7.4)岁,MMSE评分(10.6±6.5)分;同时设12名健康对照(HC),其中男7例,女5例,年龄(55.2±10.7)岁,MMSE评分(28.3±1.0)分。使用CortexID软件自动分析并导出不同参考脑区(小脑灰质、小脑、脑桥)下大脑复合皮质SUVR。采用ROC曲线确定SUVR对AD的诊断界值。结果:以小脑灰质、小脑、脑桥为参考脑区时AD组患者大脑复合皮质SUVR均高于HC组(P<0.001)。大脑复合皮质SUVR诊断界值分别为1.290、1.175和0.695,对应曲线下面积(95%CI)分别为0.977(0.851~1.000)、0.992(0.876~1.000)和0.958(0.822~0.998),在此界值下,对AD诊断敏感度分别为0.950(19/20)、1.000(20/20)、1.000(20/20),特异度分别为1.000(12/12)、0.917(11/12)、0.833(10/12)。结论:无论以小脑灰质、小脑或脑桥为参考脑区,β淀粉样蛋白PET显像的SUVR半定量分析方法对AD均有很高的诊断效能。

Aim:To explore the standard uptake value ratio(SUVR) of^(18)F-AV45 β-amyloid of cerebral cortex relative to reference regions(cerebellar gray matter, cerebellum and pons, respectively),and the threshold value of SUVR in Alzheimer′s disease(AD) patients.Methods:The date of 20 patients[4 males, 16 females;age(60.8±7.4) years;MMSE score(10.6±6.5) points] and 12 healthy controls(HC) [7 males, 5 females;age(55.2±10.7) years;MMSE score(28.3±1.0) points] were retrospectively analyzed from June 2020 to February 2022 in the First Affiliated Hospital of Zhengzhou University.The patients were all diagnosed as AD and evaluated as β-amyloid-positive according to^(18)F-AV45 PET imaging.The SUVR values of the composite cortex relative to different reference regions(cerebellar gray matter, cerebellum and pons, respectively) were automatically analyzed and derived by CortexID software.The threshold value of SUVR was obtained by ROC curve.Results:The SUVR of the composite cortex relative to cerebellar gray matter, cerebellum and pons in AD patients was significantly higher than that in HC group(P<0.001).The diagnosis threshold value of the composite cortex SUVR were 1.290,1.175 and 0.695,respectively, and the areas under the corresponding curve(95%CI) were 0.977(0.851-1.000),0.992(0.876-1.000) and 0.958(0.822-0.998),respectively.The diagnostic sensitivity for AD was 0.950(19/20),1.000(20/20),1.000(20/20),respectively;the specificity was 1.000(12/12),0.917(11/12) and 0.833(10/12).Conclusion:The SUVR semi-quantitative analysis method of^(18)F-AV45 β-amyloid PET imaging has high diagnostic efficiency for AD,no matter the reference region is cerebellar gray matter, cerebellum or pons.