抽动秽语综合征18F-FDG PET显像研究

目的分析比较正常人和抽动秽语综合征(TS)手术前后18F-FDG PET显像,探讨TS发病机制及手术治疗的可行性。方法经临床确认为TS的患者18例,行单侧苍白球切开术。术前1d和术后3月,在相同条件下分别行18F-FDG PET显像。目视法观察双侧运动区、基底节和小脑的18F-FDG分布。半定量分析法计算各观察部位与小脑18F-FDG摄取量的比值。采用全面评估抽动严重程度的YGTSS量表,对所有患者手术前后病情进行量化评估,以判断手术后的症状改善率,同时与20例正常人的脑显像比较。结果正常对照组,双侧感觉运动区皮质、双侧基底节、双侧小脑的18F-FDG呈对称分布。与正常对照比较,18例TS双侧感觉运动皮质18F-FDG摄取明显增高(P<0.01),双侧基底节18F-FDG摄取减低(P<0.05)。手术前后比较,术后手术侧感觉运动区皮质的18F-FDG分布减低(P<0.01),而基底节无明显变化(P>0.05)。18例患者术后症状改善率在63%~77%。结论双侧感觉运动区皮质18F-FDG摄取明显增高,双侧基底节18F-FDG摄取减低,为TS的18F-FDG PET显像特征。苍白球切开术明显地改善了对侧肢体抽动症状,使手术侧感觉运动区皮质18F-FDG摄取减低。

Study of 18F-FDG PET images of patients with Tourette syndrome

Objective To compare and study ~ 18 F-FDG PET images between the normal control and 18 cases with Tourette Syndrome(TS) with preoperation and postoperation to explore pathogenesis of TS and value of operative treatment. Methods 18 cases with TS were performed PET scan both before and after operation at interval of 3 months. Visual view and semiquantitive analysis of radioactive distribution were done after getting reconstrction images. Preoperative images with TS were compared with those of the normal control. Preoperative and postoperative images with TS were compared,too. In the meantime, postoperative syndrome improvement rate was calculated according to the Yale global tic severity scale. Results Compared with the normal control, there was a significant increase of uptake of ~ 18 F-FDG in the bilateral sensorimotor area and a significant decrease of ~ 18 F-FDG in the bilateral basal ganglion in TS. There was a significant decrease of radioactive distribution in the sensorimotor area in TS after pallidotomy in contrast to preoperation(P< 0.01 ), but there was no significant change between postoperation and preoperation in the basal ganglion (P> 0.05 ). Compared with preoperation, tic was remarkably improved, syndrome improvement rate ranged from 63% to 77%. Conclusion It is characteristic of ~ 18 F-FDG PET images with TS that there is an increase of radioactive distribution in the bilateral sensorimotor area and a decrease in the bilateral basal ganglion. Uptake of ~ 18 F-FDG decreases in the sensorimotor area and Tic is improved after pallidotomy.