Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.
Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.
Neuroimage Clin. 2018 May 22;19:625-632. doi: 10.1016/j.nicl.2018.05.024. eCollection 2018.
When differential diagnosis of dementia includes both Alzheimer's disease (AD) and the behavioural variant of frontotemporal dementia (bvFTD), distribution of cerebral glucose metabolism as measured using [F]‑2‑fluoro‑2‑deoxy‑d‑glucose positron emission tomography ([F]FDG-PET) may be helpful. One important clue for differentiation is the presence of hypometabolism in the posterior cingulate cortex (PCC), usually associated with AD. PCC hypometabolism however, could also be present in bvFTD. Therefore, the specificity of PCC hypometabolism was examined. Based on visual reading PCC hypometabolism was present in 69-73/81 probable AD patients, in 10-16/33 probable bvFTD patients, and in 0-1/22 cognitive normal (CN) subjects. Findings were validated using a PCC to reference tissue [F]FDG standard uptake value ratio (SUVr) cut-off, which was derived from the receiver operating characteristic (ROC) separating probable AD from CN, resulting in 9-14/33 bvFTD patients having PCC hypometabolism, depending on the reference tissue used. In conclusion, PCC hypometabolism is not restricted to AD.
当痴呆症的鉴别诊断包括阿尔茨海默病(AD)和额颞叶痴呆的行为变异型(bvFTD)时,使用[F] - 2 -氟- 2 -脱氧- d -葡萄糖正电子发射断层扫描([F] FDG-PET)测量的大脑葡萄糖代谢的分布可能会有所帮助。一个重要的鉴别线索是后扣带回皮层(PCC)的代谢低下,通常与 AD 相关。然而,PCC 代谢低下也可能存在于 bvFTD 中。因此,检查了 PCC 代谢低下的特异性。基于视觉阅读,69-73/81 例可能的 AD 患者、10-16/33 例可能的 bvFTD 患者和 0-1/22 例认知正常(CN)患者存在 PCC 代谢低下。使用从区分可能的 AD 与 CN 的接收者操作特性(ROC)中得出的 PCC 与参考组织[F] FDG 标准摄取值比(SUVr)的截断值验证了这些发现,从而导致 9-14/33 例 bvFTD 患者存在 PCC 代谢低下,具体取决于使用的参考组织。总之,PCC 代谢低下不仅限于 AD。