路易体痴呆与帕金森病伴认知功能损害患者分子影像特点研究

摘要

Objective To study the molecular imaging characteristics of dementia with Lewy bodies (DLB) and Parkinson's disease with cognitive impairment (PD-CI).Methods Six DLB patients and 15 PD-CI patients admitted to our hospital from February 2014 to December 2016 were included in this study.Their clinical history,neuropsychological and 11C-β-CFT,11 C-PIB,11C-RAC,18F-FDG imaging characteristics were retrospectively analyzed.Results The rate of symmetrical reduction of 11C-β-CFT uptake on bilateral putamen,radioactive retention of 11C-PIB in extensive cerebral cortex and glucose metabolism reduction on connected area of parietal and occipital cortex was significantly higher while that of asymmetrical reduction of 11C-β-CFT uptake on bilateral putamen was significantly lower in DLB patients than in PD-CI patients (50.0％ vs 13.3％,80.0％ vs 16.7％,100.0％ vs 40.0％,P＜0.05;33.3％ vs 86.7％,P＜0.05).Of the 3 DLB patients who underwent 11C-RAC,1 (33.3 ％) showed a lower radioactive retention of 11C-RAC in bilateral putamen and 2 showed a higher radioactive retention of 11C-RAC in bilateral putamen.The 15PD-CI patients (100.0％) showed a high radioactive retention of 11C-RAC in bilateral putamen.Conclusion Molecular imaging can show the molecular characteristics of DLB and PD-CI,thus contributing to their differential diagnosis.%目的 探讨路易体痴呆与帕金森病伴认知功能损害(Parkinson's disease with cognitive impairment,PD-CI)患者分子影像特点.方法 选择2014年2月～2016年12月解放军总医院南楼神经内科诊治的可能路易体痴呆患者6例及PD-CI患者15例,回顾分析临床病史、神经心理学特点以及11C-甲基-N-2β-甲基酯-3β-(4-氟苯基)托烷(11C-β-CFT)、11C-匹兹堡复合物B(11C-PIB)、11C-雷氯必利(11C-RAC)和18F-氟脱氧葡萄糖(18F-FDG)正电子发射断层显像特点.结果 路易体痴呆患者双侧壳核11C-β-CFT摄取对称性减低比例、皮质11C-PIB摄取增高比例以及顶枕连接区18F-FDG下降比例明显高于PD-CI患者(50.0％ vs 13.3％,80.0％ vs 16.7％,100.0％ vs 40.0％,P＜0.05);而双侧壳核11C-β-CFT摄取不对称性减低比例明显低于PD-CI患者(33.3％ vs 86.7％,P＜0.05).3例行11C-RAC显像的路易体痴呆患者中,双侧摄取减低1例(33.3％),双侧摄取增高2例(66.7％);15例(100.0％)PD-CI患者均呈现双侧摄取增高.结论 路易体痴呆与PD-CI的分子影像特征性改变,有助于两者的鉴别诊断.