18F-FDG SPECT显像诊断Alzheimer病

目的:探讨~(18)F-脱氧葡萄糖(FDG)单光子发射型电子计算机断层(SPECT)显像诊断Alzheimer病(AD)的影像特点和诊断标准。方法:静脉注射~(18)F-FDG后行脑断层显像,获得颞、顶、额叶等显像特征并加以分析。结果:早期AD 15例,简易智能状态量表(mini-mental state examination,MMSE)评分21～26分,多表现单侧尤其是优势半球或者双侧对称性异常代谢灶。中晚期AD 32例,MMSE评分<21分,表现双侧对称性异常代谢灶,累及多叶,范围更大。中晚期AD表现无代谢灶或部分无代谢灶,而早期AD显示代谢缺如较少。结论:对CT、MRI未见结构改变而MMSE评分显示认知功能缺损的患者,若~(18)F- FDG SPECT显像以单侧或双侧对称低代谢灶为主的表现,可诊断早期AD,及早行干预治疗。~(18)F-FDG SPECT可作为诊断AD分期的手段。

Diagnostic Value of 18F-FDG SPECT Image in Early Alzheimer''''s Disease

Objective:To study the image characteristics and diagnosis standard of Alzheimer's Disease(AD)with fluorine 18- fluorodeoxyglucose(18F-FDG)single photon emission computed tomography(SPECT).Methods:All patients were tomo- graphied after injection of 18F-FDG.The image characteristics of frontal lobe,parietal lobe and temporal lobe were analyzed re- spectively.Results:The MMSE scores was 21 to 26 in 15 patients with early AD,The images show unilateral(especially domi- nant hemisphere)and bilateral symmetrical abnormal metabolic areas.The MMSE scores was less than 21 in 32 subjects with middle-later periods AD.The images show bilateralsymmetrical abnormal metabolic areas and no-metabolic areas or partial no- metabolic areas,the areas involved muhy-lohe.The image of early AD seldom shows no-metabolic areas.Conclusion:18F-FDG SPECT is reliable means of the diagnosis and staging standard of AD.