Division of Geriatric Psychiatry, Columbia University, New York, USA.
J Geriatr Psychiatry Neurol. 2010 Sep;23(3):185-98. doi: 10.1177/0891988710363715. Epub 2010 Apr 29.
Amyloid load in the brain using Pittsburgh compound B ((11)C-PIB) positron emission tomography (PET) and cerebral glucose metabolism using fluorodeoxyglucose ((18)F-FDG) PET were evaluated in patients with mild Alzheimer disease (AD, n = 18), mild cognitive impairment (MCI, n = 24), and controls (CTR, n = 18). ( 11)C-PIB binding potential (BP(ND)) was higher in prefrontal cortex, cingulate, parietal cortex, and precuneus in AD compared to CTR or MCI and in prefrontal cortex for MCI compared to CTR. For (18)F-FDG, regional cerebral metabolic rate for glucose (rCMRGlu) was decreased in precuneus and parietal cortex in AD compared to CTR and MCI, with no MCI-CTR differences. For the AD-CTR comparison, precuneus BP(ND) area under the receiver operating characteristic (ROC) curve (AUC) was 0.938 and parietal cortex rCMRGlu AUC was 0.915; for the combination, AUC was 0.989. ( 11)C-PIB PET BP(ND) clearly distinguished diagnostic groups and combined with (18)F-FDG PET rCMRGlu, this effect was stronger. These PET techniques provide complementary information in strongly distinguishing diagnostic groups in cross-sectional comparisons that need testing in longitudinal studies.
采用匹兹堡复合物 B ((11)C-PIB) 正电子发射断层扫描 (PET) 检测脑内淀粉样蛋白负荷,采用氟脱氧葡萄糖 ((18)F-FDG) PET 检测脑葡萄糖代谢,对轻度阿尔茨海默病 (AD,n = 18)、轻度认知障碍 (MCI,n = 24) 和对照组 (CTR,n = 18) 患者进行评估。与 CTR 或 MCI 相比,AD 患者前额叶皮质、扣带回、顶叶皮质和楔前叶的 (11)C-PIB 结合势 (BP(ND)) 更高,而 MCI 患者前额叶皮质的 (11)C-PIB 结合势 (BP(ND)) 高于 CTR。对于 (18)F-FDG,与 CTR 和 MCI 相比,AD 患者的楔前叶和顶叶皮质的局部脑葡萄糖代谢率 (rCMRGlu) 降低,而 MCI 与 CTR 之间无差异。对于 AD-CTR 比较,楔前叶 BP(ND) 的受试者工作特征 (ROC) 曲线下面积 (AUC) 为 0.938,顶叶皮质 rCMRGlu AUC 为 0.915;联合使用时,AUC 为 0.989。(11)C-PIB PET BP(ND) 可明确区分诊断组,与 (18)F-FDG PET rCMRGlu 联合使用时,这种效果更强。这些 PET 技术在横断面比较中提供了互补信息,可在纵向研究中对其进行测试,从而有助于对诊断组进行更准确的区分。