Department of Nuclear Medicine and Nancyclotep Imaging Platform, Université de Lorraine, CHRU Nancy, 54000, Nancy, France.
Université de Lorraine, IADI, INSERM U1254, F-54000, Nancy, France.
Eur J Nucl Med Mol Imaging. 2022 Jul;49(9):3197-3202. doi: 10.1007/s00259-022-05753-5. Epub 2022 Mar 23.
This multicentre study aimed to provide a qualitative and consensual description of brain hypometabolism observed through the visual analysis of F-FDG PET images of patients with suspected neurological long COVID, regarding the previously reported long-COVID hypometabolic pattern involving hypometabolism in the olfactory bulbs and other limbic/paralimbic regions, as well as in the brainstem and cerebellum.
From the beginning of August 2021 to the end of October 2021, the brain F-FDG PET scans of patients referred for suspected neurological long COVID with positive reverse transcription polymerase chain reaction (RT-PCR) and/or serology tests for SARS-CoV-2 infection were retrospectively reviewed in three French nuclear medicine departments (143 patients; 47.4 years old ± 13.6; 98 women). Experienced nuclear physicians from each department classified brain F-FDG PET scans according to the same visual interpretation analysis as being normal, mildly to moderately (or incompletely) affected, or otherwise severely affected within the previously reported long-COVID hypometabolic pattern.
On the 143 brain F-FDG PET scans performed during this 3-month period, 53% of the scans were visually interpreted as normal, 21% as mildly to moderately or incompletely affected, and 26% as severely affected according to the COVID hypometabolic pattern. On average, PET scans were performed at 10.9 months from symptom onset (± 4.8). Importantly, this specific hypometabolic pattern was similarly identified in the three nuclear medicine departments. Typical illustrative examples are provided to help nuclear physicians interpret long-COVID profiles.
The proposed PET metabolic pattern is easily identified upon visual interpretation in clinical routine for approximately one half of patients with suspected neurological long COVID, requiring special consideration for frontobasal paramedian regions, the brainstem and the cerebellum, and certainly further adapted follow-up and medical care, while the second half of patients have normal brain PET metabolism on average 10.9 months from symptom onset.
本多中心研究旨在通过对疑似神经长新冠患者的 F-FDG PET 图像进行视觉分析，对观察到的脑代谢低下进行定性和共识描述，这些患者的 F-FDG PET 图像之前报告显示与长新冠代谢低下模式相关，涉及嗅球和其他边缘/旁边缘区域、脑桥和小脑的代谢低下。
从 2021 年 8 月初到 10 月底，对法国三个核医学部门转诊的疑似神经长新冠患者的脑部 F-FDG PET 扫描进行回顾性审查，这些患者的逆转录聚合酶链反应（RT-PCR）和/或 SARS-CoV-2 感染血清学检测均为阳性（143 例患者；47.4±13.6 岁；98 名女性）。每个部门的有经验的核医学医师根据相同的视觉解释分析，对脑 F-FDG PET 扫描进行分类，结果分为正常、轻度至中度（或不完全）受累、或根据之前报告的长新冠代谢低下模式严重受累。
在这 3 个月期间进行的 143 次脑部 F-FDG PET 扫描中，53%的扫描结果根据 COVID 代谢低下模式被视觉解释为正常，21%为轻度至中度或不完全受累，26%为严重受累。平均而言，PET 扫描是在症状出现后 10.9 个月进行的（±4.8）。重要的是，这种特定的代谢低下模式在三个核医学部门中同样得到了识别。提供了典型的说明性示例，以帮助核医学医师解释长新冠图谱。
对于疑似神经长新冠患者，大约一半患者的脑部 F-FDG PET 代谢模式可以通过临床常规的视觉解释轻松识别，需要特别注意额底旁正中区域、脑桥和小脑，当然还需要进一步进行适应的随访和医疗护理，而另一半患者的脑部 F-FDG PET 代谢在症状出现后平均 10.9 个月是正常的。
