11C-PIB PET对高龄脑淀粉样血管病患者的诊断价值*

doi:10.12047/j.cjap.5972.2020.095

中国应用生理学杂志 ›› 2020, Vol. 36 ›› Issue (5): 448-451.doi: 10.12047/j.cjap.5972.2020.095

¹¹C-PIB PET对高龄脑淀粉样血管病患者的诊断价值^*

张善春¹, 尚延昌¹, 李珂¹, 孙璇¹, 周波¹, 富丽萍², 徐白瑄², 贾建军¹, 王振福¹, 吴卫平¹

1.解放军总医院第二医学中心神经内科, 2.解放军总医院第一医学中心PET核磁室, 北京 100853

收稿日期:2019-11-14 修回日期:2020-07-27 发布日期:2021-02-25
通讯作者: ^△Tel: 13621108677; E-mail: wuwp@vip.dina.com

Value of molecular imaging in diagnosis and differential diagnosis of cerebral amyloid angiopathy

ZHANG Shan-chun, SHANG Yan-chang, LI Ke, SUN Xuan, ZHOU Bo, FU Li-ping, XU Bai-xuan, JIA Jian-jun, WANG Zhen-fu, WU Wei-ping

Received:2019-11-14 Revised:2020-07-27 Published:2021-02-25

摘要/Abstract

摘要： 目的: 研究¹¹C同位素标记的匹兹堡复合物B正电子发射显像(¹¹C-PIB PET)对高龄脑淀粉样血管病(CAA)患者的诊断作用及¹¹C-PIB沉积与脑微出血(CMB)的位置关系。方法: 选取6例非痴呆的临床可能脑淀粉样血管病(CAA)患者、14例阿尔兹海默症(AD)患者和10例对照患者行¹¹C-PIB PET检查,并同机行磁敏感成像(SWI)检查。以了解CAA患者脑内PIB沉积特点。结果: ①CAA组和AD组¹¹C-PIB PET成像皮层各脑区可见放射性滞留,对照组患者仅1例可见皮质放射性滞留。以BostonCAA诊断标准为参考,¹¹C-PIB PET诊断CAA敏感为100%,特异性为90%。②CAA组和AD组各脑区PIB沉积高于对照组(P＜0.05)。③CAA患者脑内PIB沉积低于AD组,两者无统计学差异。结论: ¹¹C -PIB PET诊断CAA敏感性高。同时合并脑叶微出血及脑凸表面铁沉积更支持CAA的诊断,有助于增加其诊断特异性。

关键词: 脑淀粉样血管病, 阿尔兹海默病, 正电子发射显像, 匹兹堡复合物B, 淀粉样蛋白β

Key words: cerebral amyloid angiopathy(CAA), positron-emission tomography(PET), pittsburgh compound-B(PIB), amyloid protein β(Aβ), aged people

张善春, 尚延昌, 李珂, 孙璇, 周波, 富丽萍, 徐白瑄, 贾建军, 王振福, 吴卫平. ¹¹C-PIB PET对高龄脑淀粉样血管病患者的诊断价值^*[J]. 中国应用生理学杂志, 2020, 36(5): 448-451.

ZHANG Shan-chun, SHANG Yan-chang, LI Ke, SUN Xuan, ZHOU Bo, FU Li-ping, XU Bai-xuan, JIA Jian-jun, WANG Zhen-fu, WU Wei-ping. Value of molecular imaging in diagnosis and differential diagnosis of cerebral amyloid angiopathy[J]. CJAP, 2020, 36(5): 448-451.

参考文献

[1] Charidimou A, Boulouis G, Gurol ME, et al. Emerging concepts in sporadic cerebral amyloid angiopathy[J]. Brain, 2017, 140(7): 1829-1850.
[2] DeSimone CV, Graff-Radford J, El-Harasis MA, et al. Cerebral amyloid angiopathy: diagnosis, clinical implications, and management strategies in atrial fibrillation[J]. J Am Coll Cardiol, 2017, 70(9): 1173-1182.
[3] Cannistraro RJ, Meschia JF, et al. The clinical dilemma of anticoagulation use in patients with cerebral amyloid angiopathy and atrial fibrillation[J]. Curr Cardiol Rep, 2018, 20(11): 106.
[4] Charidimou A, Frosch MP, Salman RA, et al. Advancing diagnostic criteria for sporadic cerebral amyloid angiopathy: Study protocol for a multicenter MRI-pathology validation of Boston criteria v2.0[J]. Int J Stroke, 2019: 1747493019855888.
[5] Bensaidane MR, Beauregard JM, Poulin S, et al. Clinical utility of amyloid PET imaging in the differential diagnosis of atypical dementias and its impact on caregivers[J]. J Alzheimers Dis, 2016, 52(4): 1251-1262.
[6] Farid K, Hong YT, Aigbirhio FI, et al. Early-phase 11C-PiB PET in amyloid angiopathy-related symptomatic cerebral hemorrhage: potential diagnostic value[J]? PLoS One, 2015, 10(10): e0139926.
[7] Farid K, Charidimou A, Baron JC, et al. Amyloid positron emission tomography in sporadic cerebral amyloid angiopathy: A systematic critical update [J]. NeuroImage-Clin, 2017, 15: 247-263.
[8] Folstein MF, Folstein SE, Mchugh PR, et al. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician[J]. J Psychiatr Res, 1975, 12(3): 189-198.
[9] Baron JC, Farid K, Dolan E, et al. Diagnostic utility of amyloid PET in cerebral amyloid angiopathy-related symptomatic intracerebral hemorrhage[J]. J Cerebr blood F Met, 2014, 34(5): 753-758.
[10]Johnson KA, Gregas M, Becker JA, et al. Imaging of amyloid burden and distribution in cerebral amyloid angiopathy[J]. Ann Neurol, 2007. 62(3):229-234.
[11]Ly JV, Donnan GA, Villemagne VL, et al. 11C-PIB binding is increased in patients with cerebral amyloid angiopathy-related hemorrhage[J]. Neurology, 2010, 74(6): 487-493.
[12]Seo SW, Ayakta N, Grinberg LT, et al. Regional correlations between [(11)C]PIB PET and post-mortem burden of amyloid-beta pathology in a diverse neuropathological cohort[J]. NeuroImage Clin, 2017, 13: 130-137.
[13]Gurol ME, PhD AVM, Christopher Gidicsin BA, et al. Cerebral amyloid angiopathy burden associated with leukoaraiosis: A positron emission tomography/magnetic resonance imaging study[J]. Ann Neurol, 2013, 73(4): 529.
[14]Lee SH, Ryu WS, Roh JK, et al. Cerebral microbleeds are a risk factor for warfarin-related intracerebral hemorrhage[J]. Neurology, 2009, 72(2): 171-176.
[15]Goos JD, Wm VDF, Knol DL, et al. Clinical relevance of improved microbleed detection by susceptibility-weighted magnetic resonance imaging[J]. Stroke, 2011, 42(7): 1894-1900.
[16]Dierksen GA, Skehan ME, Khan MA, et al. Spatial relation between microbleeds and amyloid deposits in amyloid angiopathy[J]. Ann Neurol, 2010, 68(4): 545-548.
[17]Gurol ME, Dierksen G, Betensky R, et al. Predicting sites of new hemorrhage with amyloid imaging in cerebral amyloid angiopathy[J]. Neurology, 2012, 79(4): 320-326.
[18]Johnson KA, Gregas M, Becker JA. Imaging of amyloid burden and distribution in cerebral amyloid angiopathy[J]. Ann Neurol, 2007, 62(3): 229-34.
[19]van Veluw SJ, Kuijf HJ, Charidimou A, et al. Reduced vascular amyloid burden at microhemorrhage sites in cerebral amyloid angiopathy[J]. Acta Neuropathol, 2016: 1-7.

¹¹C-PIB PET对高龄脑淀粉样血管病患者的诊断价值^*

Value of molecular imaging in diagnosis and differential diagnosis of cerebral amyloid angiopathy

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 0

编辑推荐

Metrics

本文评价