Frederiksen K S, Hasselbalch S G, Hejl A-M, Law I, Højgaard L, Waldemar G
Memory Disorders Research Group, Department of Neurology, Nuclear Medicine and PET, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Dement Geriatr Cogn Dis Extra. 2012 Jan;2(1):610-21. doi: 10.1159/000345783. Epub 2012 Dec 13.
The added diagnostic value of (11)C-PiB-PET for the assessment of the accumulation of cortical beta-amyloid in memory clinic patients with uncertain diagnosis remains undetermined.
All patients who underwent PiB-PET at the Copenhagen Memory Clinic between March 2008 and November 2011 were included in this uncontrolled, retrospective study. The standard diagnostic evaluation program included physical and neurological examination, cognitive and functional assessment, a cranial CT or MRI, functional imaging and cerebrospinal fluid sampling. Based on anonymized case reports, three experienced clinicians reached a consensus diagnosis and rated their confidence in the diagnosis before and after disclosure of PiB-PET ratings. PiB-PET scans were rated as either positive or negative.
A total of 57 patients (17 females, 30 males; age 65.7 years, range 44.2-82.6) were included in the study. Twenty-seven had a positive PiB-PET scan. At the first diagnostic evaluation, 16 patients were given a clinical Alheimer's disease diagnosis (14 PiB positive). Of the 57 patients, 13 (23%) were diagnostically reclassified after PiB-PET ratings were disclosed. The clinicians' overall confidence in their diagnosis increased in 28 (49%) patients.
PiB-PET adds to the specialist clinical evaluation and other supplemental diagnostic investigations in the diagnostic classification of patients with uncertain diagnosis in a specialized memory clinic.
对于诊断不明确的记忆门诊患者,(11)C-匹兹堡化合物B正电子发射断层扫描(PiB-PET)在评估皮质β-淀粉样蛋白积聚方面的额外诊断价值尚未确定。
纳入2008年3月至2011年11月期间在哥本哈根记忆门诊接受PiB-PET检查的所有患者进行这项非对照性回顾性研究。标准诊断评估程序包括体格检查和神经系统检查、认知和功能评估、头颅CT或MRI、功能成像以及脑脊液采样。基于匿名病例报告,三位经验丰富的临床医生达成共识诊断,并在披露PiB-PET评级前后对他们对诊断的信心进行评分。PiB-PET扫描被评为阳性或阴性。
共有57例患者(17例女性,30例男性;年龄65.7岁,范围44.2 - 82.6岁)纳入研究。27例PiB-PET扫描呈阳性。在首次诊断评估时,16例患者被临床诊断为阿尔茨海默病(14例PiB阳性)。在57例患者中,13例(23%)在披露PiB-PET评级后进行了诊断重新分类。28例(49%)患者中临床医生对其诊断的总体信心增加。
在专门的记忆门诊中,PiB-PET为诊断不明确患者的诊断分类增加了专业临床评估和其他补充诊断检查。