无脑部转移的体部恶性肿瘤患者脑静息葡萄糖代谢改变

目的 探讨无脑部转移的恶性肿瘤患者大脑静息状态下对葡萄糖摄取的变化。 方法 57例无脑部疾患的原发性体部恶性肿瘤患者接受常规全身¹⁸F-FDG PET检查,采用统计参数地形图分析软件(SPM)回顾性分析其脑部¹⁸F-FDG PET影像资料,并与年龄、性别相匹配的57名健康体检者进行比较,获得肿瘤患者大脑静息状态下葡萄糖代谢改变。 结果 恶性肿瘤患者两侧额叶(包括两侧额上回、额中回、额下回)、颞叶(包括两侧颞叶颞中回、颞下回)、部分边缘系统结构(扣带回,眶回)及小脑在静息状态下存在广泛的葡萄糖代谢减低区,额叶代谢减低以左侧为著。代谢升高区主要见于两侧海马、海马旁回、扣带回、基底节、岛叶,两侧小脑亦可见部分葡萄糖代谢升高区。 结论 无脑部转移的体部恶性肿瘤患者存在广泛的葡萄糖代谢异常区,这些脑代谢改变可能与肿瘤患者的复杂精神心理状况有关。

Regional brain metabolism changes in the body malignant tumor patients without brain metastasis

Objective To explore the change of regional brain metabolism in malignant tumor patients without brain metastasis with ¹⁸F-fluoro-deoxyglucose positron emission tomography (¹⁸F-FDG PET) under resting state. Methods Fifty-seven body malignant tumor patients without brain metastasis underwent whole body PET under resting state. The acquired brain data were retrospectively compared to the data of 57 age and gender-matched controls that underwent whole body PET/CT using software for statistical parametric mapping (SPM2). Results Compared with the control group, resting state brain hypometabolic areas in cancer patients were observed mainly in the bilateral frontal lobe (superior frontal gyrus, middle frontal gyrus and inferior frontal gyrus), temporal lobe (middle temporal gyrus, inferior temporal gyrus), part of limbic structures (cingulate gyrus, orbitalfrontal cortex) and cerebellum. Hypometabolism in the frontal lobe was left-side dominant. Hypermetabolic areas were observed in the bilateral hippocampus, parahippocampal gyrus, cingulate gyrus, basal ganglia, insular and cerebellum. Conclusion Body malignant tumor patients without brain metastasis have extensive abnormal metabolic areas in frontal lobe, temporal lobe and the part of limbic structures, which may reflect the complicated psychological deficits in cancer patients.