^(11)C-PIB PET定性及半定量分析在鉴别诊断阿尔茨海默病中的价值

The value of qualitative and semi-quantitative analysis of 11 C-PIB PET in the differential diagnosis of Alzheimer s disease

目的探讨通过11 C-匹兹堡化合物B(11 C-Pittsburgh compound B,11 C-PIB)正电子发射计算机断层显像(positron emission tomography,PET)定性及半定量分析脑内β-淀粉样蛋白(β-amyloid,Aβ)沉积程度,评价其对阿尔茨海默病(Alzheimer’s disease,AD)、轻度认知障碍(mild cognitive impairment,MCI)及非阿尔茨海默病所致认知障碍(non Alzheimer s disease induced cognitive impairment,NAD)的诊断及鉴别诊断价值。方法回顾性分析首都医科大学宣武医院神经内科2022年收治的AD患者(AD,n=36)、轻度认知障碍患者(MCI,n=20)、非AD所致认知障碍患者(NAD,n=19)及健康对照者(normal control,NC,n=10)作为研究对象。此85例受试者均行11 C-PIB PET显像,首先对脑内是否有Aβ沉积做阴性或阳性定性判断,再以脑干为参考脑区对大脑皮质额、顶、颞、枕叶Aβ沉积最大标准化摄取值比值(maximum standardized uptake value ratio,SUVRmax)半定量测量,并分析AD、MCI、NAD及NC组之间SUVRmax的差异。结果定性判断显示,AD组、NC组与其他各组之间差异有统计学意义,MCI组与NAD组之间差异无统计学意义。半定量分析显示,对于所有的脑区(额叶、顶叶、颞叶、枕叶),AD组的SUVRmax值都明显高于其他3个组,差异有统计学意义。在所有脑区中,NC组的SUVRmax数值最低,但SUVRmax在MCI组、NAD及NC组之间差异无统计学意义。结论11 C-PIB PET显像定性及半定量分析对诊断AD均有较高价值,半定量分析对AD及MCI有一定的鉴别意义。

Objective To investigate the diagnostic and differential diagnostic value of 11 C-Pittsburgh compound B(11 C-PIB)positron emission tomography(PET)imaging for Alzheimer s disease(AD),mild cognitive impairment(MCI)and non-Alzheimer s disease induced cognitive impairment(NAD)by qualitatively and semi quantitatively evaluating the degree of β-amyloid(Aβ)deposition in the brain.Methods AD patients(AD,n=36),mild cognitive impairment(MCI,n=20),non-AD induced cognitive impairment(NAD,n=19),and normal controls(NC,n=10)admitted to the Department of Neurology,Xuanwu Hospital,Capital Medical University in 2022 were retrospectively analyzed.All 85 subjects underwent 11 C-PIB PET imaging.First,AβNegative or positive deposition was qualitatively estimated,and then taking the brainstem as the reference brain area,the maximum standardized uptake value ratio(SUVRmax)of the frontal,parietal,temporal,and occipital lobes of the cerebral cortex Aβ was semi-quantitative measured,and the differences of SUVRmax among AD,MCI,NAD.and NC groups were analyzed.Results Qualitative judgment showed that there were significant differences between AD group,NC group,and other groups,but no significant difference between MCI group and NAD group.Semi quantitative analysis showed that for all brain regions(frontal lobe,parietal lobe,temporal lobe,occipital lobe),the SUVRmax value of AD group was significantly higher than that of the other three groups,with a statistically significant difference.In all brain regions,the SUVRmax value of NC group was the lowest,but there was no significant difference in SUVRmax among MCI group,NAD and NC group.Conclusion Both qualitative and semi quantitative analysis of 11 C-PIB PET imaging were of high value in the diagnosis of AD,and semi quantitative analysis showed certain significance in differentiating AD and MCI.