FDG-PET/CT对急性脑血管病意识障碍患者脑功能评估的价值及其危险因素分析

目的探讨氟化脱氧葡萄糖(FDG)-PET/CT对急性脑血管病意识障碍患者脑功能评估的价值,并分析患者意识恢复情况的危险因素。方法选取2015年12月—2020年12月浙江省台州医院收治的急性脑血管病意识障碍患者170例作为研究对象,根据出院时修订版昏迷恢复量表(CRS-R)评分将其分为意识恢复组(73例)和意识未恢复组(97例)。收集临床资料,进行FDG-PET/CT检查,并测量左右侧不同感兴趣脑区标准摄取值(SUV)。采用ROC曲线分析不同感兴趣脑区SUV对患者意识恢复情况的评估价值,采用多因素logistic回归分析影响患者意识恢复情况的危险因素。结果意识未恢复组患者入院时CRS-R评分及顶叶、枕叶、颞叶、额叶、丘脑、小脑、基底节SUV明显低于意识恢复组(均P<0.05),脑积水构成比明显高于意识恢复组(P<0.05)。意识未恢复组患者左右侧顶叶、枕叶、颞叶、额叶、丘脑、小脑、基底节SUV差异均无统计学意义(均P>0.05)。不同感兴趣脑区SUV联合评估急性脑血管病患者意识恢复情况的曲线下面积大于顶叶、枕叶、颞叶、额叶、丘脑、小脑、基底节SUV单独检查(均P<...

Value of FDG-PET/CT in the assessment of brain function and its risk factors in patients with acute cerebrovascular disease and consciousness disorder

  Objective  To investigate the value of fluoride deoxyglucose (FDG)-PET/CT in the assessment of brain function in patients with acute cerebrovascular disease with consciousness disorder and analyse its risk factors.  Methods  A total of 170 patients with acute cerebrovascular disease and consciousness disorder, who were treated in our hospital from December 2015 to December 2020, were selected as the research objects, and they were divided into the consciousness recovery group (73 cases) and the unconsciousness group (97 cases) based on the scores of the Revised Coma Recovery Scale (CRS-R) at the time of discharge from the hospital. The clinical data were collected. FDG-PET/CT examination was performed, and the standard uptake values (SUVs) of different brain regions of interest on the left and right sides were measured. The ROC curve was used to analyse the evaluation value of SUV in different brain regions of interest for the recovery of consciousness in patients with acute cerebrovascular disease, and the multivariate Logistic regression model was used to analyse the risk factors affecting the recovery of consciousness.  Results  The CRS-R score and SUVs of the parietal lobe, occipital lobe, temporal lobe, frontal lobe, thalamus, cerebellum and basal ganglia in the unrecovered consciousness group were significantly lower than those in the recovered consciousness group (all P < 0.05), but the composition ratio of the hydrocephalus in the recovered consciousness group was significantly higher than that in the consciousness recovery group (P < 0.05). No statistically significant difference in SUVs of the parietal lobe, occipital lobe, temporal lobe, frontal lobe, thalamus, cerebellum and basal ganglia was found between the left and right brain of patients with the unconsciousness group (all P>0.05). The area under the curve of the combination of SUVs in different brain regions of interest in the assessment of the recovery of consciousness in patients with acute cerebrovascular disease was higher than that of SUV of the parietal lobe, occipital lobe, temporal lobe, frontal lobe, thalamus, cerebellum and basal ganglia alone (all P < 0.05). The sensitivity was 96.90%, and the specificity was 85.10%. The SUVs of the parietal lobe, occipital lobe, temporal lobe, frontal lobe, thalamus, cerebellum and basal ganglia were considered as risk factors affecting the recovery of consciousness in patients with acute cerebrovascular disease (all P < 0.05).  Conclusion  FDG-PET/CT examination is important to assess the brain function of patients with consciousness disorder and acute cerebrovascular disease.