Department of Nuclear Medicine, Ajou University School of Medicine, Suwon, Korea.
Clin Nucl Med. 2012 Jul;37(7):663-8. doi: 10.1097/RLU.0b013e3182478bf2.
We investigated the pattern of reduced and increased metabolism in symptomatic Huntington chorea (HD) patients and assessed the influence of intensity normalization method.
FDG brain PET was performed in 11 manifest HD patients and 11 age-matched controls. Images underwent statistical parametric mapping analysis after global normalization or with white matter or pons as reference region. Region of interest analysis of FDG uptake ratios was also performed using total region or white matter as reference. Correlation between regional uptake ratios to that of the caudate was evaluated by linear regression analysis.
Although statistical parametric mapping analysis identified striatal hypometabolism and thalamic hypermetabolism in HD patients with all methods, substantially different FDG uptake patterns were shown depending on the method of intensity normalization. Global normalization displayed large areas of relative normalized hypermetabolism across the cerebral cortex and cerebellum. With white matter as reference, relative normalized hypermetabolism was observed in the thalamus and a much more limited area of the cortex. With pons as reference, relative normalized hypermetabolism was largely confined to the thalamus and a small area of the cerebellum.
These results demonstrate apparent relative normalized hypermetabolism in selective brain regions in manifest HD patients. Furthermore, the choice of reference region for intensity normalization is critical for accurate monitoring of this metabolic change with FDG PET.
我们研究了有症状亨廷顿舞蹈病（HD）患者代谢减少和增加的模式，并评估了强度归一化方法的影响。
对 11 名有症状的 HD 患者和 11 名年龄匹配的对照者进行了 FDG 脑 PET 检查。图像经过全局归一化或使用白质或脑桥作为参考区域进行统计参数映射分析。还使用总区域或白质作为参考进行了 FDG 摄取率的感兴趣区域分析。通过线性回归分析评估了区域摄取率与尾状核摄取率的相关性。
尽管所有方法均通过统计参数映射分析识别出 HD 患者纹状体代谢减少和丘脑代谢亢进，但强度归一化方法的不同导致了明显不同的 FDG 摄取模式。全局归一化显示大脑皮层和小脑整个区域相对归一化的代谢过度。使用白质作为参考，丘脑和皮质的一个更小区域观察到相对归一化的代谢过度。使用脑桥作为参考，相对归一化的代谢过度主要局限于丘脑和小脑的一个小区域。
这些结果表明，在有症状的 HD 患者中，选择性脑区存在明显的相对归一化代谢过度。此外，对于使用 FDG PET 准确监测这种代谢变化，参考区域的选择对于强度归一化至关重要。
