Piert M, Koeppe R A, Giordani B, Minoshima S, Kuhl D E
Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor 48109, USA.
J Nucl Med. 1996 Jul;37(7):1115-22.
Dynamic [18F]fluorodeoxyglucose (FDG) PET was used in Parkinson's disease patients and normal controls to determine kinetic rate constants for FDG. The goal was to assess whether the metabolic decreases observed in Parkinson's disease are associated with transport or phosphorylation processes or both.
Fluorine-18-FDG was administered to 18 Parkinson's disease and 15 normal control subjects. Dynamic PET scanning was performed for 1 h and rate constants were obtained by nonlinear, least-squares analysis. Regional glucose metabolic rate was calculated from the individually fitted rate constants and by two standard static scan analyses.
Global CMRglu was decreased in Parkinson's disease (mean reduction 22%), reaching statistical significance in all regions investigated. K1 was significantly reduced in parietal cortex, temporal cortex and striatum while k3 was significantly reduced only in parietal cortex. The rate constant k2 was unchanged.
K1, k3 and CMRglu all demonstrated greater deficits across the brain with progression of disease and development of dementia, particularly in the parietal an occipital cortex. This suggested that the metabolic disturbance may be a global dysfunction throughout the brain. Because altered rate constants are specifically taken into account, dynamic measurements has shown to provide higher sensitivity for detecting diminished glucose utilization in Parkinson's disease than static approaches.
对帕金森病患者和正常对照者使用动态[18F]氟脱氧葡萄糖（FDG）PET来确定FDG的动力学速率常数。目的是评估在帕金森病中观察到的代谢降低是否与转运或磷酸化过程或两者都有关。
对18例帕金森病患者和15名正常对照者给予氟-18-FDG。进行1小时的动态PET扫描，并通过非线性最小二乘法分析获得速率常数。根据个体拟合的速率常数并通过两种标准静态扫描分析计算区域葡萄糖代谢率。
帕金森病患者的整体葡萄糖代谢率（CMRglu）降低（平均降低22%），在所有研究区域均达到统计学显著性。顶叶皮质、颞叶皮质和纹状体中的K1显著降低，而k3仅在顶叶皮质中显著降低。速率常数k2未改变。
随着疾病进展和痴呆的发展，K1、k3和CMRglu在全脑均表现出更大的缺陷，尤其是在顶叶和枕叶皮质。这表明代谢紊乱可能是全脑的整体功能障碍。由于特别考虑了改变的速率常数，动态测量已显示出比静态方法在检测帕金森病中葡萄糖利用减少方面具有更高的灵敏度。
