^18F-AV45PET显像在轻微认知下降和轻度认知障碍患者中的应用

目的 探讨^18F-AV45 PET显像检测的轻微认知下降(SCD)和轻度认知障碍(MCI)患者脑β-淀粉样蛋白(Aβ)沉积与患者认知状态的关系.方法 将上海交通大学附属第六人民医院2018年12月至2019年3月间诊断为SCD或MCI,且在2周内行^18F-AV45 PET显像、脑MRI T1扫描和简易精神状态检查量表(MMSE)检查的24例患者纳入研究,前瞻性收集数据,其中男11例、女13例,年龄(63.2±7.6)岁;SCD 15例、MCI 9例.对^18F-AV45 PET图像进行目测分析(阳性、弱阳性、阴性);再基于MRI图像对PET图像进行预处理后进行半定量分析,选择8个感兴趣区(ROI):额叶、外侧顶叶、外侧颞叶、内侧颞叶、枕叶、基底神经节、后扣带回和楔前叶,以小脑灰质为参考区,计算Aβ沉积的标准摄取值比值(SUVR),并计算偏相关系数,分析不同脑区SUVR与MMSE的相关性.结果 24例患者中,PET显像示Aβ沉积阳性16例、弱阳性8例,各脑区SUVR范围为0.93~1.87,MMSE评分为(28.2±2.0)分.MMSE评分与额叶皮质(r=-0.432)、后扣带回(r=-0.434)和楔前叶(r=-0.418)的SUVR呈负相关(均P<0.05),余脑区的SUVR与MMSE的相关性均无统计学意义(r值:-0.412^-0.110,均P>0.05).结论 ^18F-AV45 PET显像能无创性检测脑Aβ沉积,并在一定程度上反映SCD和MCI患者的临床认知状态.

Application of ^18F-AV45 PET imaging in subtle cognitive decline and mild cognitive impairment patients

Objective To investigate the correlations between cerebralβ-amyloid(Aβ)deposition assessed by ^18F-florbetapir(AV45)PET imaging and clinical cognitive symptoms in patients with subtle cognitive decline(SCD)and mild cognitive impairment(MCI).Methods Data of twenty-four patients(11 males,13 females,age:(63.2±7.6)years)diagnosed as SCD(n=15)or MCI(n=9)from December 2018 to March 2019 in Shanghai Jiao Tong University Affiliated Sixth People′s Hospital were collected prospectively.All patients underwent ^18F-AV45 PET imaging,brain MRI T1 scan and Mini-Mental State Examination(MMSE)within two weeks.^18F-AV45 PET images were analyzed visually(positive,mild positive,negative).After being pretreated according to the MRI,^18F-AV45 PET images were analyzed semi-quantitatively by calculating the standardized uptake value ratio(SUVR)of Aβdeposition in 8 regions of interest(ROIs;frontal lobe,lateral parietal lobe,lateral temporal lobe,medial temporal lobe,occipital lobe,basal ganglia,posterior cingulate and precuneus),with cerebellar gray matter as the reference.Partial correlation coefficients between regional SUVRs and MMSE score were calculated.Results ^18F-AV45 PET imaging showed that 16 patients with positive results and 8 patients with mild positive results.MMSE score of 24 patients was 28.2±2.0,and the SUVR was 0.93-1.87.Correlation analysis revealed that Aβdeposition in frontal cortex(r=-0.432),posterior cingulate lobe(r=-0.434)and precuneus(r=-0.418)was negatively correlated with MMSE score(all P<0.05);and no significant correlations between SUVR and MMSE in other brain regions were found(r values:from-0.412 to-0.110,all P>0.05).Conclusion ^18F-AV45 PET imaging can noninvasively detect brain Aβdeposition in patients,and can effectively reflect the clinical cognitive status of patients with SCD and MCI to a certain extent.