氟代脱氧葡萄糖正电子发射断层扫描与单光子发射计算机断层扫描的扣带回岛征在阿尔茨海默病与路易体痴呆轻度认知功能障碍评估中的对比。
The Cingulate Island Sign on FDG-PET vs. IMP-SPECT to Assess Mild Cognitive Impairment in Alzheimer's Disease vs. Dementia with Lewy Bodies.
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, Yokohama Maioka Hospital, 3482 Maiokacho, Totsuka-Ku, Yokohama City, Kanagawa, 244-0813, Japan.
出版信息
J Neuroimaging. 2019 Nov;29(6):712-720. doi: 10.1111/jon.12643. Epub 2019 Jun 14.
BACKGROUND AND PURPOSE
The cingulate island sign (CIS) on F-fluorodeoxyglucose positron emission tomography (FDG-PET); ie, the relative preservation of mid-posterior cingulate cortex metabolism, is a supportive biomarker in the diagnostic criteria for dementia with Lewy bodies (DLB). However, limited information is currently available on the diagnostic value of the CIS on FDG-PET or I-iodoamphetamine single-photon emission computed tomography (IMP-SPECT) for differentiating between mild cognitive impairment (MCI) due to Alzheimer's disease (AD) (MCI-AD) and MCI due to DLB (MCI-DLB).
METHODS
We examined the CIS ratio in 9 AD patients, 9 DLB patients, 8 patients with MCI-AD, and 9 patients with MCI-DLB using FDG-PET and IMP-SPECT. The CIS ratio was calculated using NEUROSTAT software.
RESULTS
In the dementia groups, a receiver operating characteristic analysis of the CIS ratio showed significant accuracy for differentiating between AD and DLB on FDG-PET and IMP-SPECT. In the MCI groups, only the FDG-PET derived CIS ratio displayed significant accuracy for differentiating between AD and DLB.
CONCLUSIONS
The FDG-PET and IMP-SPECT derived CIS ratios are both useful for differentiating between AD and DLB. The FDG-PET derived CIS ratio is more valuable than the IMP-SPECT derived CIS ratio for differential diagnosis in patients with MCI. A larger study is needed to confirm these results.
背景与目的
在 F-氟脱氧葡萄糖正电子发射断层扫描（FDG-PET）中，扣带回岛征（CIS），即中后扣带回皮质代谢相对保留，是路易体痴呆（DLB）诊断标准中的一个支持性生物标志物。然而，目前关于 CIS 在 FDG-PET 或 I-碘安非他命单光子发射计算机断层扫描（IMP-SPECT）上对区分阿尔茨海默病（AD）所致轻度认知障碍（MCI）（MCI-AD）和 DLB 所致 MCI（MCI-DLB）的诊断价值的信息有限。
方法
我们使用 FDG-PET 和 IMP-SPECT 检查了 9 例 AD 患者、9 例 DLB 患者、8 例 MCI-AD 患者和 9 例 MCI-DLB 患者的 CIS 比值。CIS 比值使用 NEUROSTAT 软件计算。
结果
在痴呆组中，CIS 比值的受试者工作特征分析在 FDG-PET 和 IMP-SPECT 上对 AD 和 DLB 的鉴别具有显著准确性。在 MCI 组中，只有 FDG-PET 衍生的 CIS 比值对 AD 和 DLB 的鉴别具有显著准确性。
结论
FDG-PET 和 IMP-SPECT 衍生的 CIS 比值均可用于区分 AD 和 DLB。在 MCI 患者中，FDG-PET 衍生的 CIS 比值比 IMP-SPECT 衍生的 CIS 比值更有助于鉴别诊断。需要更大的研究来证实这些结果。
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