18F-氟脱氧葡萄糖正电子发射断层扫描显示小脑共济失调患者不同的亚区域代谢模式。
Different subregional metabolism patterns in patients with cerebellar ataxia by 18F-fluorodeoxyglucose positron emission tomography.
作者信息
Oh Minyoung, Kim Jae Seung, Oh Jungsu S, Lee Chong Sik, Chung Sun Ju
机构信息
Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
出版信息
PLoS One. 2017 Mar 20;12(3):e0173275. doi: 10.1371/journal.pone.0173275. eCollection 2017.
We evaluated cerebellar subregional metabolic alterations in patients with cerebellar ataxia, a representative disease involving the spinocerebellum. We retrospectively analyzed 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) images in 44 patients with multiple system atrophy of the cerebellar type (MSA-C), 9 patients with spinocerebellar ataxia (SCA) type 2, and 14 patients with SCA type 6 and compared with 15 patients with crossed cerebellar diaschisis (CCD) and 89 normal controls. Cerebellar subregional metabolism was assessed using 13 cerebellar subregions (bilateral anterior lobes [ANT], superior/mid/inferior posterior lobes [SUPP/MIDP/INFP], dentate nucleus [DN], anterior vermis [ANTV], and superior/inferior posterior vermis [SUPV/INFV]) to determine FDG uptake ratios. MSA-C and SCA type 2 showed severely decreased metabolic ratios in all cerebellar subregions compared to normal controls (ANT, 0.58 ± 0.08 and 0.50 ± 0.06 vs. 0.82 ± 0.07, respectively, p < 0.001). SCA type 6 showed lower metabolic ratios in almost all cerebellar subregions (ANT, 0.57 ± 0.06, p < 0.001) except INFV. Anterior-posterior lobe ratio measurements revealed that SCA type 2 (Right, 0.81 ± 0.05 vs. 0.88 ± 0.04, p < 0.001; Left, 0.83 ± 0.05 vs. 0.88 ± 0.04, p = 0.003) and SCA type 6 (Right, 0.72 ± 0.05 vs. 0.88 ± 0.04, p < 0.001; Left, 0.72 ± 0.05 vs. 0.88 ± 0.04, p < 0.001) showed preferential hypometabolism in the anterior lobe compared to normal controls, which was not observed in CCD and MSA-C. Asymmetric indices were higher in CCD and MSA-C than in normal controls (p < 0.001), whereas such differences were not found in SCA types 2 and 6. In summary, quantitative analysis of cerebellar subregional metabolism ratios revealed preferential involvement of the anterior lobe, corresponding to the spinocerebellum, in patients with cerebellar ataxia, whereas patients with CCD and MSA-C exhibited more asymmetric hypometabolism in the posterior lobe.
我们评估了小脑共济失调患者小脑亚区域的代谢改变，小脑共济失调是一种涉及脊髓小脑的典型疾病。我们回顾性分析了44例小脑型多系统萎缩（MSA-C）患者、9例2型脊髓小脑共济失调（SCA）患者和14例6型SCA患者的18F-氟脱氧葡萄糖正电子发射断层扫描（18F-FDG PET）图像，并与15例交叉性小脑失联络（CCD）患者和89名正常对照进行比较。使用13个小脑亚区域（双侧前叶[ANT]、上/中/下后叶[SUPP/MIDP/INFP]、齿状核[DN]、小脑蚓部前叶[ANTV]以及上/下后蚓部[SUPV/INFV]）评估小脑亚区域代谢，以确定FDG摄取率。与正常对照相比，MSA-C和2型SCA在所有小脑亚区域的代谢率均严重降低（ANT分别为0.58±0.08和0.50±0.06，而正常对照为0.82±0.07，p<0.001）。除INFV外，6型SCA在几乎所有小脑亚区域的代谢率均较低（ANT为0.57±0.06，p<0.001）。前后叶比率测量显示，2型SCA（右侧，0.81±0.05 vs. 0.88±0.04，p<0.001；左侧，0.83±0.05 vs. 0.88±0.04，p = 0.003）和6型SCA（右侧，0.72±0.05 vs. 0.88±0.04，p<0.001；左侧，0.72±0.05 vs. 0.88±0.04，p<0.001）与正常对照相比，前叶存在优先低代谢，而CCD和MSA-C未观察到这种情况。CCD和MSA-C的不对称指数高于正常对照（p<0.001），而2型和6型SCA未发现此类差异。总之，小脑亚区域代谢率的定量分析显示，小脑共济失调患者中对应于脊髓小脑的前叶优先受累，而CCD和MSA-C患者后叶表现出更明显的不对称性低代谢。
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