Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China.
Health Management Center, Tianjin Medical University General Hospital Airport Site, Tianjin, China.
CNS Neurosci Ther. 2024 Feb;30(2):e14418. doi: 10.1111/cns.14418. Epub 2023 Aug 21.
To analyze the value of F-fluorodeoxyglucose (FDG) positron emission tomography (PET) combined with amyloid PET in cognitive impairment diagnosis.
A total of 187 patients with dementia or mild cognitive impairment (MCI) who underwent C-Pittsburgh compound B (PiB) and FDG PET scans in a memory clinic were included in the final analysis.
Amyloid-positive and amyloid-negative dementia patient groups showed a significant difference in the proportion of individuals presenting temporoparietal cortex (p < 0.001) and posterior cingulate/precuneus cortex (p < 0.001) hypometabolism. The sensitivity and specificity of this hypometabolic pattern for identifying amyloid pathology were 72.61% and 77.97%, respectively, in patients clinically diagnosed with AD and 60.87% and 76.19%, respectively, in patients with MCI. The initial diagnosis was changed in 32.17% of patients with dementia after considering both PiB and FDG results. There was a significant difference in both the proportion of patients showing the hypometabolic pattern and PiB positivity between dementia conversion patients and patients with a stable diagnosis of MCI (p < 0.05).
Temporoparietal and posterior cingulate/precuneus cortex hypometabolism on FDG PET suggested amyloid pathology in patients with cognitive impairment and is helpful in diagnostic decision-making and predicting AD dementia conversion from MCI, particularly when combined with amyloid PET.
分析 F-氟脱氧葡萄糖（FDG）正电子发射断层扫描（PET）联合淀粉样 PET 在认知障碍诊断中的价值。
最终分析了在记忆诊所接受 C-匹兹堡化合物 B（PiB）和 FDG PET 扫描的 187 名痴呆或轻度认知障碍（MCI）患者。
淀粉样阳性和淀粉样阴性痴呆患者组在颞顶叶皮层（p < 0.001）和后扣带回/楔前叶皮层（p < 0.001）代谢低下的个体比例上存在显著差异。这种代谢低下模式识别淀粉样蛋白病理学的敏感性和特异性分别为临床诊断为 AD 的患者 72.61%和 77.97%，MCI 的患者分别为 60.87%和 76.19%。考虑到 PiB 和 FDG 结果后，痴呆患者中有 32.17%的初始诊断发生了改变。在认知障碍转换患者和 MCI 稳定诊断患者之间，显示代谢低下模式和 PiB 阳性的患者比例存在显著差异（p < 0.05）。
FDG PET 显示的颞顶叶和后扣带回/楔前叶皮层代谢低下提示淀粉样蛋白病理学存在于认知障碍患者中，有助于诊断决策和预测从 MCI 向 AD 痴呆的转化，尤其是与淀粉样 PET 结合时。
