摘要目的 研究抗N-甲基-D-天冬氨酸受体(NMDAR)脑炎患者不同时期脑18F-氟代脱氧葡萄糖(2-[18F] fluoro-2-deoxy-D-glucose,18 F-FDG) PET-CT显像的表现及该技术在判断疾病进展与预后中的价值.方法 连续入组10例经确诊的抗NMDAR脑炎患者,在其疾病不同时期进行脑18F-FDGPET-CT显像,并结合临床特征进行分析.结果 10例抗NMDAR脑炎患者中有2例脑18F-FDG PET-CT显像正常,8例脑18F-FDG PET-CT显像提示疾病早期在额颞叶、基底节及小脑18F-FDG代谢增高;随着疾病进展,基底节18F-FDG代谢逐渐减低,随后其他部位代谢开始减低,以左侧侧大脑及右侧小脑为主.结论 抗NMDAR脑炎患者在疾病不同时期的脑18F-FDG PET-CT显像表现为18F-FDG由增高到减低的过程,可能累及部位主要有额颞枕顶叶皮质、基底节及小脑,以左侧大脑半球及右侧小脑为主;复发型患者此特征性改变不明显.

abstractsObjective To demonstrate the manifestations on positron emission tomographycomputed tomography (PET-CT) at different stages in anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis.Methods PET-CT was performed in 10 patients with anti-NMDAR encephalitis at different clinical stages,and the images were analyzed to investigate the relation of metabolic patterns in the images with clinical presentations.Results Except for normal PET-CT images in 2 patients,images in 8 patients at early stage of the disease showed generally increased 2-[18F] fluoro-2-Deoxy-D-glucose(18F-FDG) uptake at frontal and temporal lobe,basal ganglion and cerebellum,indicating hyper-metabolism in these areas,while 2 of them also had mixture of hyper-and hypo-metabolism in parietal-occipital region.In longitudinal analysis of PET-CT images in these 8 cases,starting at basal ganglion,18 F-FDG uptake gradually decreased bilaterally,prominently at left dominant hemisphere and right cerebellum.Conclusions During the course of anti-NMDAR encephalitis,18F-FDG metabolism markedly increases at early stage and then gradually declines at late stage,at frontal,temporal,parietal and occipital lobes,basal ganglion and cerebellum,predominantly at left dominant hemisphere and right cerebellum.However,in relapsing anti-NMDAR encephalitis,18 F-FDG metabolism in brain does not show these characteristics.