PET/MR混合成像11C-PIB PET影像的统计参数映射辅助半定量分析及其临床应用研究

中华核医学与分子影像杂志 Pub Date : 2020-04-25 DOI:10.3760/CMA.J.CN321828-20200211-00040

Xun Sun, W. Ruan, Xiaojuan Huang, Fang Liu, Xuehan Hu, Yongkang Gai, Qingyao Liu, X. Lan

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引用次数: 0

摘要

目的探讨统计参数定位(SPM)辅助半定量分析PET/MR混合成像11C-Pittsburgh compound B (PIB) β-amyloid (Aβ) PET图像的可行性，并评价其辅助诊断或鉴别诊断认知功能障碍的可能性。方法2018年1月~ 2019年9月对13例阿尔茨海默病(AD)患者(男4例，女9例;年龄(59.2±5.8)岁)，血管性认知障碍(VCD)患者10例(男9例，女1例;回顾性分析华中科技大学同济医学院协和医院PET中心11C-PIB PET/MR患者的年龄(59.5±11.5)岁。在同步三维T1加权成像(3D T1WI)的帮助下，通过人工圈定和spm辅助半自动分割，获得脑白质、纹状体、丘脑、扣带回后区、额叶皮层、后顶叶皮层、外侧颞叶皮层和枕叶皮层8个关键脑区与小脑皮层的标准化摄取值比(SUVR)。对两种方法得到的SUVR进行Pearson相关分析。采用独立样本t检验和配对t检验对数据进行分析。结果AD组与VCD组在年龄、MMSE评分(19.7±4.7 vs 21.7±3.8)上无显著差异;t值分别为0.095和1.098,P值均为0.05)。除丘脑(r=0.179, P=0.413)外，其他7个关键区域的分割所得SUVR与圈定结果均有较好的相关性(r值为0.678 ~ 0.893，均P<0.05)。两种方法获得的8个关键区域的SUVR, AD组显著高于VCD组(1.519-2.055 vs 1.105-1.618;t值:2.799 ~ 11.582,P均<0.01)。AD组纹状体(1.942±0.205)、扣带回后回(1.915±0.249)、额叶(1.983±0.264)、顶叶(2.008±0.296)、颞叶(1.931±0.254)的SUVR显著高于脑白质(1.746±0.192);t值:3.793 ~ 6.992,P均<0.01)。而在VCD组，没有任何区域的SUVR高于脑白质。结论PET/MR混合成像可同步获取PET和MRI图像，可在SPM辅助下实现准确的脑区分割，获得脑关键区域的半定量数据。该方法可分析AD与VCD的淀粉样蛋白影像学特征及差异，有望为认知障碍的诊断和鉴别诊断提供准确的影像学分析方法。关键词:阿尔茨海默病;认知障碍;淀粉样蛋白;正电子发射断层扫描;磁共振成像

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Study of statistical parametric mapping aided semi-quantitative analysis of 11C-PIB PET imaging acquired by hybrid PET/MR and its clinical application

Objective To explore the feasibility of statistical parametric mapping (SPM) aided semi-quantitative analysis in 11C-Pittsburgh compound B (PIB) β-amyloid (Aβ) PET imaging acquired by hybrid PET/MR, and evaluate its possibility in assisting the diagnosis or differential diagnosis for cognitive impairment. Methods From January 2018 to September 2019, 13 Alzheimer′s disease (AD) patients (4 males, 9 females; age (59.2±5.8) years) and 10 vascular cognitive disorders (VCD) patients (9 males, 1 female; age (59.5±11.5) years) who underwent 11C-PIB PET/MR in PET center of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology were retrospectively analyzed. The standardized uptake value ratio (SUVR) of eight key brain regions (cerebral white matter, striatum, thalamus, posterior cingulate gyrus, frontal cortex, posterior parietal cortex, lateral temporal cortex and occipital cortex) to cerebellum cortex were obtained by manual delineation and SPM-aided semi-automatic segmentation with the help of synchronous three-dimensional T1 weighted imaging (3D T1WI). Pearson correlation analysis was carried out on the SUVR obtained by the two methods. Independent-sample t test and paired t test were used to analyze the data. Results There was no significant difference between AD group and VCD group in age and Mini-Mental State Examination (MMSE) score (19.7±4.7 vs 21.7±3.8; t values: 0.095 and 1.098, both P>0.05). Except thalamus(r=0.179, P=0.413), there were good correlations between SUVR obtained by segmentation and delineation in the other 7 key regions (r values: 0.678-0.893, all P<0.05). The SUVR of 8 key regions obtained by the two methods in AD group was significantly higher than that in VCD group (1.519-2.055 vs 1.105-1.618; t values: 2.799-11.582, all P<0.01). The SUVR of striatum (1.942±0.205), posterior cingulate gyrus (1.915±0.249), frontal lobe (1.983±0.264), parietal lobe (2.008±0.296) and temporal cortex (1.931±0.254) in AD group was significantly higher than that of cerebral white matter (1.746±0.192; t values: 3.793-6.992, all P<0.01). But in VCD group, there was no region with the SUVR higher than that of cerebral white matter. Conclusions Hybrid PET/MR can acquire the PET and MRI images synchronously, which can realize the accurate brain segmentation and obtain the semi-quantitative data of key brain regions aided by SPM. The method can analyze the characteristics and differences of amyloid imaging in AD and VCD, which is expected to provide an accurate imaging analysis method for the diagnosis and differential diagnosis of cognitive disorders. Key words: Alzheimer disease; Cognition disorders; Amyloid; Positron-emission tomography; Magnetic resonance imaging

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来源期刊

中华核医学与分子影像杂志核医学，分子影像

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5088

期刊介绍： Chinese Journal of Nuclear Medicine and Molecular Imaging (CJNMMI) was established in 1981, with the name of Chinese Journal of Nuclear Medicine, and renamed in 2012. As the specialized periodical in the domain of nuclear medicine in China, the aim of Chinese Journal of Nuclear Medicine and Molecular Imaging is to develop nuclear medicine sciences, push forward nuclear medicine education and basic construction, foster qualified personnel training and academic exchanges, and popularize related knowledge and raising public awareness. Topics of interest for Chinese Journal of Nuclear Medicine and Molecular Imaging include: -Research and commentary on nuclear medicine and molecular imaging with significant implications for disease diagnosis and treatment -Investigative studies of heart, brain imaging and tumor positioning -Perspectives and reviews on research topics that discuss the implications of findings from the basic science and clinical practice of nuclear medicine and molecular imaging - Nuclear medicine education and personnel training - Topics of interest for nuclear medicine and molecular imaging include subject coverage diseases such as cardiovascular diseases, cancer, Alzheimer’s disease, and Parkinson’s disease, and also radionuclide therapy, radiomics, molecular probes and related translational research.