摘要目的 通过11C-2β-甲氧甲酰-3β-(4-氟苯基)托烷(CFT)和18F-脱氧葡萄糖(FDG)PET/CT脑显像研究震颤与非震颤帕金森病(PD)患者的代谢特点.方法 纳入2018年3月至2019年3月的PD患者28例[震颤组19例:男14例、女5例,年龄(59.9±11.4)岁;非震颤组9例:男3例、女6例,年龄(62.6±9.o)岁].采用感兴趣区(ROI)技术进行计算,比较2组患者尾状核、前壳核和后壳核11C-CFT摄取值及各脑区18F-FDG的摄取值.采用两样本t检验或Mann-Whitney u检验分析数据.结果 震颤组PD患者的尾状核11C-CFT摄取值明显高于非震颤组(3.03±0.51与2.60±0.62;t=2.687,P＜0.05),而非震颤组患者丘脑18F-FDG的摄取值明显高于震颤组(1.14±0.05与1.10±0.03;t=3.449,P＜0.01).以改良Hoehn-Yahr分级判定病情严重程度,震颤组患者在疾病进展期(分级≥2.5级)壳核和小脑葡萄糖代谢均较非震颤组进展期增高(1.27±0.04与1.21±0.05,0.94±0.04与0.86±0.08;t值:2.695和2.492,均P＜0.05),震颤组进展期运动前区代谢较早期减低(1.07±0.02与1.10±0.03;t=2.053,P＜0.05).结论 11C-CFT和18F-FDG PET/CT显像能较好地反映震颤与非震颤PD患者的不同代谢特征,有助于2种疾病亚型的临床诊疗和鉴别诊断.

abstractsObjective To investigate the metabolic patterns of 11C-2-beta-carbomethoxy-3-beta-(4-fluorophenyl)tropane (CFF) and 18F-fluorodeoxyglucose (FDG) PET/CT imaging in patients with tremor and non-tremor Parkinson's disease (PD).Methods From March 2018 to March 2019,28 PD patients (19 tremor patients:14 males and 5 females,age:(59.9±11.4) years;9 non-tremor patients:3 males and 6 females,age:(62.6±9.0) years) were enrolled.For the two groups,the 11C-CFT uptake values in caudate nucleus,anterior putamen and posterior putamen as well as 18F-FDG uptake values in all brain regions were calculated by regions of interest (ROI) method.Two-sample t test or Mann-Whitney u test were used to analyze the data.Results Caudate nucleus 11C-CFT uptake in PD patients with tremor was higher than that without tremor (3.03±0.51 vs 2.60±0.62;t =2.687,P＜0.05).Yet thalamus glucose uptake of non-tremor PD patients showed more active than tremor patients (1.14±0.05 vs 1.10±0.03;t =3.449,P＜0.01).Sorted by modified Hoehn-Yahr stage,tremor patients in advanced stage (stage≥2.5) were characterized by glucose uptake increase in the putamen and cerebellum compared with non-tremor advanced group (1.27±0.04 vs 1.21±0.05,0.94±0.04 vs 0.86±0.08;t values:2.695 and 2.492,both P＜0.05).Metabolic decrease in the premotor areas was observed in tremor patients in advanced stage compared with early stage (1.07±0.02vs 1.10±0.03;t=2.053,P＜0.05).Conclusion 11C-CFT and 18F-FDG PET/CT imaging can indicate different metabolic patterns between tremor and non-tremor PD,thus providing information for clinical practice and differential diagnosis.