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目的 探讨帕金森病 (PD)患者1 8F 脱氧葡萄糖 (FDG)PET脑代谢显像的影像学特征及其临床意义。方法 静脉注射1 8F FDG后行脑断层显像 ,获得 33例PD患者及 32例正常人纹状体、丘脑、黑质、顶叶、颞叶、额叶、枕叶、海马单位面积放射性计数与小脑计数的比值 (Rcl cb) ,并与MRI进行对照。结果 正常人脑PET显像可见大脑各叶、基底节、丘脑、中脑及小脑放射性分布均匀对称。PD患者的PET异常率为 96 .97% ,MRI异常率为 30 .30 %。PD患者黑质、纹状体、丘脑及大脑半球各叶代谢低于正常人 ,差异有非常显著性 (P <0 .0 0 1) ,并与症状严重程度有关。症状重侧肢体对侧脑半球的黑质、纹状体、丘脑及额叶代谢较另侧降低。PD患者PET显像特征 :非对称性黑质(93 94% )、纹状体 (6 9.70 % )、丘脑 (36 .36 % )代谢减低 ;非对称性纹状体或丘脑代谢轻度增高 ,占15 15 % ;非对称性大脑各叶代谢下降 ,其中以颞叶 (5 1.5 2 % )、额叶 (39.39% )、海马 (4 5 .46 % )为著 ;非对称性额叶、颞叶、海马代谢轻度增高占 9.0 9%。结论 在除外脑内结构特异性损害基础上 ,1 8F FDGPET发现单侧或不对称性双侧黑质、纹状体、丘脑代谢减低或轻度增高有助PD的早期诊断。
Objective To investigate the imaging features and clinical significance of cerebral metabolic imaging in 18F-FDG PET in patients with Parkinson’s disease (PD). Methods The 18F FDGs were injected intravenously into the brain and the brains of 33 patients with PD and 32 normal controls were obtained. The radioactive counts per unit area of the thalamus, substantia nigra, parietal lobe, temporal lobe, frontal lobe, occipital lobe and hippocampus Cerebellar count ratio (Rcl cb), and compared with MRI. Results Normal brain PET imaging showed that the lobes of basal ganglia, basal ganglia, thalamus, midbrain and cerebellum were evenly and symmetrically distributed. The abnormal rate of PET in patients with PD was 96.97% and the abnormal rate of MRI was 30.3%. Metabolism of substantia nigra, striatum, thalamus and hemisphere in PD patients was lower than that in normal people, the difference was significant (P <0.01), and was related to the severity of symptoms. Symptoms Metabolism of the substantia nigra, striatum, thalamus and frontal lobe of the contralateral hemisphere in the contralateral hemiplegia was lower than that in the other side. PET imaging features of PD patients: asymmetric substantia nigra (93.94%), striatum (6. 9.70%), thalamus (36.36%) decreased metabolism; asymmetric striatum or hypothalamus slightly increased metabolism, Accounting for 15 15%; asymptomatic decline in the metabolism of each leaf of the brain, of which the temporal lobe (5 1.52%), frontal lobe (39.39%), hippocampus (45.66%); asymmetric frontal lobe, temporal Leaf, hippocampal metabolism increased slightly 9.09%. Conclusion In addition to the structural damage specific to the brain, 18F FDGPET found that bilateral unilateral or asymmetric bilateral substantia nigra, striatum, hypothalamus metabolism may contribute to the early diagnosis of PD.