论文部分内容阅读
目的研究 P 型多系统萎缩(multiple system atrophy,MSA-P)与帕金森病(Parkinson’sdisease,PD)的脑部葡萄糖代谢差异。方法 MSA-P 患者15例,PD 患者32例,无神经系统疾病的健康对照8名,进行~(18)F-脱氧葡萄糖(FDG)PET 检查。分别取尾状核、豆状核、丘脑、小脑、双侧额叶、双侧顶叶、双侧颞叶和双侧枕叶为感兴趣区(ROI)。应用 PET 专用软件计算各 ROI 的 FDG 放射性同位素值,以颅内各部位 ROI 的~(18)F-FDG 代谢比值为指标。结果 MSA-P 的额叶、颞叶、顶叶、纹状体、丘脑的~(18)F-FDG 脑代谢与健康对照和帕金森病相比呈现对称性下降;丘脑~(18)F-FDG 代谢高于纹状体以及额、顶叶皮质;~(18)F-FDG 代谢比值同侧豆状核与丘脑为0.493±0.085,同侧尾状核头与丘脑为0.453±0.079。PD 的额、顶、颞叶皮质~(18)F-FDG 代谢分别高于纹状体、丘脑;纹状体高于丘脑,首发症状肢体对侧豆状核与丘脑~(18)F-FDG 代谢比值为1.131±0.113;基底节代谢不对称。MSA-P 的豆状核与丘脑~(18)F-FDG 代谢比值,同 PD 的豆状核与丘脑~(18)F-FDG 代谢比值相比差异有统计学意义(P<0.01)。结论MSA-P 与帕金森病的葡萄糖代谢差异显著,可以应用~(18)F-FDG PET 检查作为鉴别诊断的重要方法之一。
Objective To investigate the difference of glucose metabolism in brain between P-type multiple system atrophy (MSA-P) and Parkinson’s disease (PD). Methods Fifteen patients with MSA-P, 32 patients with PD, and 8 healthy controls without neurological diseases were examined with 18 F-FDG PET. The caudate nucleus, lentiform nucleus, thalamus, cerebellum, bilateral frontal lobe, bilateral parietal lobe, bilateral temporal lobe and bilateral occipital lobe were selected as ROIs. The PET specific software was used to calculate the FDG radioisotope values of each ROI, and the ~ (18) F-FDG metabolic ratio of ROI in each part of the brain was taken as an index. Results Compared with healthy controls and Parkinson’s disease, the brain metabolism of 18 F-FDG in frontal lobe, temporal lobe, parietal lobe, striatum and thalamus of MSA-P decreased. FDG metabolism was higher than that of the striatum as well as the amount of parietal and parietal cortex; ~ (18) F-FDG metabolic ratio ipsilateral lentiform nucleus and thalamus 0.493 ± 0.085, ipsilateral caudate nucleus and thalamus 0.453 ± 0.079. Metabolism of F-FDG in frontal, cortex and temporal lobe cortex were higher than that in the striatum and thalamus, striatum was higher than that in the thalamus, and the first symptom was contralateral leptoid nucleus and thalamic ~ (18) F-FDG metabolism Ratio was 1.131 ± 0.113; basal ganglia metabolic asymmetry. MSA-P ratio of lean to thalamus ~ (18) F-FDG had statistical significance (P <0.01) compared with the ratio of PD to putamen and (18) F-FDG in thalamus. Conclusion There is significant difference in glucose metabolism between MSA-P and Parkinson’s disease. ~ (18) F-FDG PET can be used as one of the important methods for differential diagnosis.