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进行性核上性麻痹的临床、MRI 和 18F-FDG-PET/CT 分析。

Clinical, MRI and 18F-FDG-PET/CT analysis of progressive supranuclear palsy.

机构信息

Department of Neurology, Second Hospital of Tianjin Medical University, No. 23, Pingjiang Road, Hexi District, Tianjin 300211, China.

Department of Neurology, General Hospital of Tianjin Medical University, No. 154, Anshan Road, Heping District, Tianjin 300052, China.

出版信息

J Clin Neurosci. 2020 Oct;80:318-323. doi: 10.1016/j.jocn.2020.06.008. Epub 2020 Jul 7.

Abstract

BACKGROUND

Progressive supranuclear palsy (PSP) is a kind of neurodegenerative disease. In the present study, the clinical and magnetic resonance imaging (MRI) features of PSP were analyzed, and fluorodeoxyglucose positron emission tomography (FDG PET) brain imaging was performed to preliminarily explore the characteristics of cerebral glucose metabolism, so as to make a more accurate and differential diagnosis.

METHODS

In accordance with the diagnostic criteria, the clinical symptoms, the unified Parkinson's disease rating scale (UPDRS), the mini-mental state examination (MMSE), the activities of daily living (ADL), and the magnetic resonance image (MRI) of 19 patients with PSP were examined and FDG-PET brain imaging was performed. Visual analysis and statistical parameter diagram were used to analyze the characteristics.

RESULTS

Concerning the clinical characteristics, 84.21% of the patients with PSP had early recurrent falls, 63.15% had vertical supranuclear ophthalmoplegia, and 47.37% had symptoms of dementia. The MRI scans showed that 57.89% of the patients had a "hummingbird" sign in the middle sagittal position. The FDG-PET imaging indicated that glucose metabolism in the midbrain and frontal lobe was decreased in patients with PSP.

CONCLUSIONS

Studying the clinical and MRI features of patients with PSP can be helpful in the diagnosis, especially as some signs could be found in the early stage by FDG PET, enhancing early diagnosis and differentiation.

摘要

背景

进行性核上性麻痹(PSP)是一种神经退行性疾病。本研究分析了 PSP 的临床和磁共振成像(MRI)特征,并进行了氟代脱氧葡萄糖正电子发射断层扫描(FDG PET)脑成像,初步探讨了脑葡萄糖代谢的特征,以便更准确地进行鉴别诊断。

方法

根据诊断标准,对 19 例 PSP 患者的临床症状、统一帕金森病评定量表(UPDRS)、简易精神状态检查(MMSE)、日常生活活动(ADL)和磁共振成像(MRI)进行了检查,并进行了 FDG-PET 脑成像。采用视觉分析和统计参数图对特征进行分析。

结果

在临床特征方面,84.21%的 PSP 患者有早期复发性跌倒,63.15%有垂直性核上性眼肌麻痹,47.37%有痴呆症状。MRI 扫描显示,57.89%的患者在中矢状位有“蜂鸟”征。FDG-PET 成像显示,PSP 患者中脑和额叶的葡萄糖代谢降低。

结论

研究 PSP 患者的临床和 MRI 特征有助于诊断,特别是 FDG PET 可以在早期发现一些特征,从而增强早期诊断和鉴别。

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