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目的对新生儿缺氧缺血性脑病(hypoxic-ischemic encephalopathy,HIE)患儿应用18氟脱氧葡萄糖(18F-FDG)正电子发射断层显像(PET)测定脑葡萄糖代谢,探讨PET测定脑葡萄糖代谢在新生儿HIE中的临床应用价值。方法选择健康足月新生儿9例、早产儿7例和HIE患儿8例,共24例,在注射37 MBq/kg18F-FDG后应用PET测定脑葡萄糖代谢。结果早产儿和健康足月新生儿脑18F-FDG PET显像,其葡萄糖代谢活性区主要在丘脑较高[SUV值分别为(0.71±0.11)、(1.74±0.41)],在大脑皮层较低;足月新生儿大脑皮层摄取的葡萄糖活性较早产儿为高,结构较为清晰;HIE患儿脑存在明显葡萄糖代谢异常,主要表现为:大脑皮层18F-FDG摄取量不一致,如损伤一侧明显低于对侧,或某区域低于其他区域;全脑葡萄糖代谢偏低,尤其是皮层下白质、丘脑、基底节等部位最明显。结论早产儿和健康足月新生儿脑18F-FDG PET显像有自身特点,HIE患儿脑存在明显葡萄糖代谢异常,应用18F-FDG PET测定脑葡萄糖代谢为判断新生儿脑组织损伤程度提供了新的方法。
Objective To determine brain glucose metabolism in 18 neonates with hypoxic-ischemic encephalopathy (HIE) by 18F-FDG PET and to explore the role of PET in determining brain glucose metabolism In neonatal HIE clinical value. Methods Nine healthy full-term newborns, 7 preterm infants and 8 HIE infants were selected. A total of 24 infants were enrolled in this study. PET was used to measure brain glucose metabolism after 37 MBq / kg 18F-FDG injection. Results 18F-FDG PET imaging of preterm infants and healthy full-term newborns showed that the areas of glucose metabolism were mainly located in the thalamus. The SUV values were (0.71 ± 0.11) and (1.74 ± 0.41), respectively, lower in the cerebral cortex ; The glucose uptake in cerebral cortex of term neonates was higher than those in preterm infants, and the structure was clearer. There was significant glucose metabolism abnormality in brain of HIE children. The main manifestations were as follows: the uptake of 18F-FDG in cerebral cortex was inconsistent, In the contralateral, or a region lower than other regions; whole brain glucose metabolism is low, especially in the subcortical white matter, thalamus, basal ganglia and other parts of the most obvious. Conclusion 18F-FDG PET imaging in preterm infants and healthy full-term newborns has its own characteristics. There is a significant abnormal glucose metabolism in the brain of HIE infants. The use of 18F-FDG PET in determining brain glucose metabolism provides a new measure of brain injury in neonates Methods.