National Stroke Research Institute, Level 1, Neurosciences Building, Austin Health, University of Melbourne, 300 Waterdale Rd., Heidelberg Heights, Victoria 3081, Australia.
Neurology. 2010 Feb 9;74(6):487-93. doi: 10.1212/WNL.0b013e3181cef7e3.
The in vivo diagnosis of cerebral amyloid angiopathy (CAA) is inferred from clinical and structural imaging features. (11)C-Pittsburgh compound B (PIB) is a PET ligand that binds to beta-amyloid in extracellular plaques and vessel walls. We hypothesized that patients with a clinical diagnosis of CAA-related hemorrhage (CAAH) have increased (11)C-PIB uptake and that the pattern differs from Alzheimer disease (AD).
Patients with CAAH based on established clinical criteria were studied using (11)C-PIB PET and were compared with age-matched controls and patients with AD. Distribution volume ratio (DVR) parametric maps were created using the cerebellar cortex as a reference region.
Twelve patients with CAAH of mean age 73.9 (range 58-93) years were compared with 22 normal controls and 13 patients with AD of mean age 71.8 (59-83) and 73.8 (56-90) years, respectively. CAAH PIB median DVR binding was higher in cortical regions (1.69, interquartile range 1.44-1.97) compared with controls (1.32, 1.21-1.44, p = 0.002) but lower than AD (2.04, 1.93-2.26, p = 0.004). The occipital-global uptake ratio was lower among patients with AD than among patients with CAAH (p = 0.008), and the frontal-global uptake ratio was higher (p = 0.012).
(11)C-Pittsburgh compound B (PIB) binding is moderately increased in most patients with probable cerebral amyloid angiopathy (CAA)-related intracerebral hemorrhage. The distribution may differ from that seen in Alzheimer disease. (11)C-PIB PET may assist in the in vivo diagnosis of CAA and serve as a surrogate marker for future therapeutic studies.
脑淀粉样血管病（CAA）的体内诊断是根据临床和结构影像学特征推断出来的。（11）C-Pittsburgh 化合物 B（PIB）是一种 PET 配体，可与细胞外斑块和血管壁中的β淀粉样蛋白结合。我们假设，具有 CAA 相关性脑出血（CAAH）临床诊断的患者具有增加的（11）C-PIB 摄取，并且其模式与阿尔茨海默病（AD）不同。
根据既定的临床标准，对 CAAH 患者进行（11）C-PIB PET 研究，并与年龄匹配的对照组和 AD 患者进行比较。使用小脑皮层作为参考区域创建分布容积比（DVR）参数图。
12 名平均年龄为 73.9 岁（范围为 58-93 岁）的 CAAH 患者与 22 名正常对照者和 13 名平均年龄为 71.8 岁（59-83 岁）和 73.8 岁（56-90 岁）的 AD 患者进行了比较。与对照组相比，皮质区的 CAAH PIB 中位 DVR 结合较高（1.69，四分位间距 1.44-1.97）（1.32，1.21-1.44，p=0.002），但低于 AD（2.04，1.93-2.26，p=0.004）。与 CAAH 患者相比，AD 患者的枕叶-全局摄取比值较低（p=0.008），而额叶-全局摄取比值较高（p=0.012）。
在大多数可能患有脑淀粉样血管病（CAA）相关性颅内出血的患者中，（11）C-Pittsburgh 化合物 B（PIB）的结合适度增加。其分布可能与阿尔茨海默病所见不同。（11）C-PIB PET 可能有助于 CAA 的体内诊断，并作为未来治疗研究的替代标志物。
