Jiménez-Bonilla J F, Quirce R, de Arcocha-Torres M, Martínez-Rodríguez I, Martínez-Amador N, Sánchez-Juan P, Pozueta A, Martín-Láez R, Banzo I, Rodríguez-Rodríguez E
Nuclear Medicine Department, University Hospital Marqués de Valdecilla, University of Cantabria, Molecular imaging Group - IDIVAL, Santander, Cantabria, España.
Nuclear Medicine Department, University Hospital Marqués de Valdecilla, University of Cantabria, Molecular imaging Group - IDIVAL, Santander, Cantabria, España.
Rev Esp Med Nucl Imagen Mol (Engl Ed). 2018 Mar-Apr;37(2):87-93. doi: 10.1016/j.remn.2017.07.006. Epub 2017 Aug 30.
Cortical cerebral amyloid disease, a hallmark of Alzheimer's disease, has also been observed in idiopathic normal pressure hydrocephalus (iNPH). The aim of this study was to compare the C-PIB PET/CT retention pattern in iNPH patients and healthy subjects.
A comparison was made of the C-PIB PET/CT retention pattern in 13 iNPH patients selected for surgical deviation, compared to a normal control population. Images were visually analyzed and scored for gray matter and white matter (WM) from 1 to 4 (slight to very high PIB retention). The scoring was analyzed in both groups separately for infra- and supra-tentorial regions. A comprehensive clinical report was presented in terms of positive, negative, or equivocal.
C-PIB PET/CT scan were reported as negative in 8, positive in 3, and equivocal in 2. Five of 13 patients showed at least one cortical area with PIB retention with an intensity higher than that observed in the control group. Overall, white matter (WM) PIB retention of iNPH scored lower than in the control group, showing a statistically significant difference in the infratentorial WM (92/104 vs 54/56; p<.05) and a tendency to be lower in the supratentorial regions (70/84 vs 122/156, p=.327), in particular in the upper periventricular region (25/28 vs 40/52; p=.134).
The PIB retention pattern seems to be different in NPH, compared to normal subjects. PIB retention in WM of NPH appears less intense than in healthy subjects, and they show a higher degree of PIB retention in cortical regions. This deserves to be taken it into account.
皮质脑淀粉样变是阿尔茨海默病的一个标志，在特发性正常压力脑积水（iNPH）中也有观察到。本研究的目的是比较iNPH患者和健康受试者的C-PIB PET/CT滞留模式。
将13例因手术分流而入选的iNPH患者的C-PIB PET/CT滞留模式与正常对照人群进行比较。对图像进行视觉分析，并对灰质和白质（WM）从1到4分进行评分（PIB滞留程度从轻度到非常高）。分别对幕下和幕上区域的两组评分进行分析。以阳性、阴性或不确定的形式给出综合临床报告。
C-PIB PET/CT扫描报告为阴性的有8例，阳性的有3例，不确定的有2例。13例患者中有5例至少有一个皮质区域出现PIB滞留，其强度高于对照组。总体而言，iNPH患者白质（WM）的PIB滞留评分低于对照组，幕下白质存在统计学显著差异（92/104 vs 54/56；p<0.05），幕上区域有降低趋势（70/84 vs 122/156，p = 0.327），特别是在脑室周围上部区域（25/28 vs 40/52；p = 0.134）。
与正常受试者相比，NPH患者的PIB滞留模式似乎有所不同。NPH患者WM中的PIB滞留似乎不如健康受试者强烈，且在皮质区域表现出更高程度的PIB滞留。这一点值得考虑。
