阿尔茨海默病与路易体痴呆的早期鉴别诊断：(18)F-FDG PET与(123)I-IMP SPECT的比较
Early differential diagnosis between Alzheimer's disease and dementia with Lewy bodies: Comparison between (18)F-FDG PET and (123)I-IMP SPECT.
作者信息
Chiba Yuhei, Iseki Eizo, Fujishiro Hiroshige, Ota Kazumi, Kasanuki Koji, Suzuki Masaru, Hirayasu Yoshio, Arai Heii, Sato Kiyoshi
机构信息
PET/CT Dementia Research Center, Juntendo Tokyo Koto Geriatric Medical Center, Juntendo University School of Medicine, 3-3-20 Shinsuna, Koto-ku, Tokyo 136-0075, Japan; Department of Psychiatry, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan; Department of Psychiatry, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama-shi, Kanagawa 236-0004, Japan.
PET/CT Dementia Research Center, Juntendo Tokyo Koto Geriatric Medical Center, Juntendo University School of Medicine, 3-3-20 Shinsuna, Koto-ku, Tokyo 136-0075, Japan; Department of Psychiatry, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan.
出版信息
Psychiatry Res Neuroimaging. 2016 Mar 30;249:105-12. doi: 10.1016/j.pscychresns.2015.12.007. Epub 2015 Dec 28.
Both (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET) and (123)I-iodoamphetamine (IMP) single-photon emission computed tomography (SPECT) have been used for the differential diagnosis of Alzheimer's disease (AD) and dementia with Lewy bodies (DLB). Less information is available, however, regarding the differential diagnosis of mild cognitive impairment (MCI) due to AD and MCI due to DLB. We examined nine AD patients (AD group), nine DLB patients (DLB group), eight MCI due to AD patients (MCI-AD group), and nine MCI due to DLB patients (MCI-DLB group) with FDG PET and IMP SPECT using a well-characterized normal database and a stereotactic extraction estimation method. In the AD and DLB groups, receiver operating characteristic (ROC) analysis in the occipital regions showed significant accuracy of both FDG PET and IMP SPECT for the differential diagnosis. In the MCI-AD and MCI-DLB groups, ROC analysis showed significant accuracy of only FDG PET for the differential diagnosis. Both FDG PET and IMP SPECT would be useful for the differential diagnosis between AD and DLB. For the differential diagnosis of MCI-AD versus MCI-DLB, FDG PET would be more useful than IMP SPECT.
氟代脱氧葡萄糖（FDG）正电子发射断层扫描（PET）和碘安非他明（IMP）单光子发射计算机断层扫描（SPECT）均已用于阿尔茨海默病（AD）和路易体痴呆（DLB）的鉴别诊断。然而，关于AD所致轻度认知障碍（MCI）和DLB所致MCI的鉴别诊断，相关信息较少。我们使用特征明确的正常数据库和立体定向提取估计方法，对9例AD患者（AD组）、9例DLB患者（DLB组）、8例AD所致MCI患者（MCI-AD组）和9例DLB所致MCI患者（MCI-DLB组）进行了FDG PET和IMP SPECT检查。在AD组和DLB组中，枕叶区域的受试者操作特征（ROC）分析显示，FDG PET和IMP SPECT在鉴别诊断方面均具有显著准确性。在MCI-AD组和MCI-DLB组中，ROC分析显示仅FDG PET在鉴别诊断方面具有显著准确性。FDG PET和IMP SPECT均有助于AD和DLB的鉴别诊断。对于MCI-AD与MCI-DLB的鉴别诊断，FDG PET比IMP SPECT更有用。
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