18F-AV45 PET/CT显像视觉分析及SUVR对不同认知障碍患者的辅助诊断价值n

来源 :中华核医学与分子影像杂志 | 被引量 : 0次 | 上传用户:muscleprince
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目的:探讨n 18F-AV45 PET/CT脑显像中视觉分析、标准摄取值比值(SUVR)对不同认知障碍患者大脑内β-淀粉样蛋白(Aβ)沉积情况的评估以及临床辅助诊断价值。n 方法:自2018年12月至2019年7月共纳入47例(名)受试者,包括5名[男3名、女2名,年龄(58±13)岁]健康人对照(NC)、8例[男2例、女6例,年龄(66±10)岁]阿尔茨海默病(AD)患者和34例[男16例、女18例,年龄(70±7)岁]轻度认知障碍(MCI)患者。对所有纳入者行n 18F-AV45 PET/CT检查,进行视觉分析,并计算SUVR。对视觉分析和SUVR的诊断效率采用McNemar检验比较,一致性采用n Kappa检验分析;组间比较采用单因素方差分析及Welch检验。另外,通过受试者工作特征(ROC)曲线分析获得SUVR的最佳界值。n 结果:SUVR和视觉分析评估的全部受试Aβ沉积阳性率分别是46.81%(22/47)和38.30%(18/47),差异无统计学意义(n χ2=33.15,n P>0.05),一致性较好(n Kappa=0.83)。以临床诊断为“金标准”,视觉分析与SUVR均可鉴别AD和NC:灵敏度分别为7/8和8/8,特异性均为5/5(n χ2=9.48,n P>0.05),一致性较好(n Kappa=0.84)。SUVR定量分析可以鉴别AD与NC组、AD与MCI组,组间SUVR差异有统计学意义(n F值:3.99~8.79,均n P0.05)。ROC曲线分析示,楔前叶SUVR>1.08对AD与NC的鉴别诊断效能最高;侧颞叶SUVR>1.06是鉴别AD与MCI的最佳界值。n 结论:在n 18F-AV45 PET/CT显像中,视觉分析与SUVR定性判断大脑Aβ沉积能力一致,而SUVR定量分析可以辅助鉴别AD与NC、AD与MCI。n “,”Objective:To evaluate the value of visual analysis and standardized uptake value ratio (SUVR) during n 18F-florbetapir (AV45) PET/CT brain imaging in diagnosis of β-amyloid (Aβ) deposition in patients with mild cognitive impairment (MCI) and Alzheimer′s disease (AD), and to explore the clinical ancillary value of the two indexes.n Methods:From December 2018 to July 2019, a total of 47 subjects, including 5 (3 males, 2 females, age (58±13) years) normal controls (NC), 8 (2 males, 6 females, age (66±10) years) patients with AD and 34 (16 males, 18 females, age (70±7) years) patients with MCI were enrolled. All subjects underwent n 18F-AV45 PET/CT scan. All images were evaluated by visual analysis and SUVR were calculated. The diagnostic efficiencies of visual analysis and SUVR were compared by McNemar test and n Kappa test. One-way analysis of variance and Welch test were used to compare data differences. The best threshold value of SUVR was obtained by receiver operating characteristic (ROC) curve analysis.n Results:The positive rate of Aβ deposition for all subjects was 46.81%(22/47) by SUVR analysis, and 38.30%(18/47) by visual analysis. There was no significant difference between the two methods (n χ2=33.15, n P>0.05), and the consistency was good (n Kappa=0.83). Considering the clinical diagnosis as the“gold standard”, the Aβ deposition obtained by visual analysis and SUVR analysis can effectively distinguish AD from NC, and the sensitivities were 7/8n vs 8/8, respectively, both specificities were 5/5(n χ2=9.48, n P>0.05), with good consistency (n Kappa=0.84). SUVR quantitative analysis could distinguish AD from NC, AD from MCI (n F values: 3.99-8.79, all n P0.05). ROC curve analysis showed that the best threshold value of precuneus′ SUVR was 1.08 for the differential diagnosis of AD and NC; for the differential diagnosis of AD and MCI, the best threshold value of lateral temporal′s SUVR was 1.06.n Conclusion:Visual analysis was consistent with SUVR′s qualitative determination during n 18F-AV45 PET/CT imaging for brain Aβ deposition, while SUVR quantitative analysis could assist in the differential diagnosis of AD and NC, AD and MCI.n
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