摘要
目的分析^(18)F-脱氧葡萄糖正电子发射计算机断层扫描(^(18)F-FDG PET/CT)定量参数与内分水岭脑梗死(IWSI)梗死面积、认知功能障碍的关系,分析其对患者预后的预测价值,为临床诊疗提供参考。方法选取2022年1月至2023年5月河北省沧州中西医结合医院收治的114例IWSI患者,根据头颅磁共振成像(MRI)显示梗死面积,比较不同梗死面积IWSI患者^(18)F-FDG PET/CT定量参数[标准化摄取值(SUV)],进行认知功能障碍评估,比较不同认知功能障碍程度IWSI患者^(18)F-FDG PET/CT定量参数。随访1个月,采用改良Rankin量表(mRS)评估预后,分为预后良好组(75例)、预后不良组(39例),分析^(18)F-FDG PET/CT定量参数对IWSI患者预后的预测价值。结果小面积梗死组额叶SUV、顶叶SUV、枕叶SUV、颞叶SUV、小脑SUV均高于中面积梗死组、大面积梗死组,中面积梗死组各脑区SUV均高于大面积梗死组(P<0.05)。4组额叶SUV、顶叶SUV、枕叶SUV、颞叶SUV、小脑SUV比较,均为无认知功能障碍组>轻度认知障碍组>中度认知障碍组>重度认知障碍组(P<0.05)。IWSI患者额叶SUV、顶叶SUV、枕叶SUV、颞叶SUV、小脑SUV与梗死面积、认知功能障碍均呈负相关(P<0.05)。预后良好组IWSI患者额叶SUV、顶叶SUV、枕叶SUV、颞叶SUV、小脑SUV均高于预后不良组(P<0.05)。^(18)F-FDG PET/CT定量参数预测IWSI患者预后的受试者工作特征曲线,结果显示各脑区参数联合预测的曲线下面积最大,为0.910(P<0.05)。结论IWSI梗死面积、认知功能障碍均与^(18)F-FDG PET/CT定量参数密切相关,联合各脑区SUV对IWSI预后具有较高预测价值,可作为IWSI梗死面积、认知功能障碍及近期预后不良的有效指标。
Objective To analyze the relationship between the quantitative parameters of 18F-deoxyglucose positron emission computed tomography(18F-FDG PET/CT)and the infarct area and cognitive dysfunction of internal watershed cerebral infarction(IWSI),and to analyze its prognostic value for patients,and provide reference for clinical diagnosis and treatment.Methods A total of 114 patients with IWSI admitted to Cangzhou Hospital of Integrated Chinese and Western Medicine,Hebei Province from January 2022 to May 2023 were selected.According to the infarct area shown by head magnetic resonance imaging(MRI),the 18F-FDG PET/CT quantitative parameters[standard uptake value(SUV)]of IWSI patients with different infarct area were compared to evaluate cognitive dysfunction,and the 18F-FDG PET/CT quantitative parameters of IWSI patients with different degrees of cognitive dysfunction were compared.The prognosis was assessed by the modified Rankin Scale(mRS)for 1 month,and was divided into good prognosis group(75 patients)and poor prognosis group(39 patients).The predictive value of 18F-FDG PET/CT quantitative parameters in IWSI patients was analyzed.Results SUV in frontal,parietal,occipital,temporal and cerebellar areas in the small infarct group were higher than those in medium and large infarct groups,and SUV in all brain areas in the medium infarct group were higher than those in the large infarct group(P<0.05).Frontal SUV,parietal SUV,occipital SUV,temporal SUV and cerebellar SUV in no cognitive impairment group were all higher than those in the mild cognitive impairment group>those in the moderate cognitive impairment group>those in the severe cognitive impairment group(P<0.05).Frontal SUV,parietal SUV,occipital SUV,temporal SUV and cerebellar SUV were negatively correlated with infarct area and cognitive dysfunction in IWSI patients(P<0.05).The SUV in frontal lobe,parietal lobe,occipital lobe,temporal lobe and cerebellar lobe of IWSI patients with good prognosis were higher than those in poor prognosis group(P<0.05).The receiver operating characteristic curve of 18F-FDG PET/CT quantitative parameters predicted the prognosis of IWSI patients,and the results showed that area under the curve of the combined prediction of each brain region was the largest,0.910(P<0.05).Conclusion Infarct area and cognitive dysfunction of IWSI are closely related to the quantitative parameters of 18F-FDG PET/CT.The combination of SUV in different brain regions has high predictive value for IWSI prognosis,and can be used as an effective indicator of IWSI infarct area,cognitive dysfunction and poor short-term prognosis.
作者
李培党
路凯
马宇
LI Peidang;LU Kai;MA Yu(Department of Nuclear Medicine,Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine,Hebei Province,Cangzhou,Hebei 061000,China)
出处
《转化医学杂志》
2025年第5期85-90,共6页
Translational Medicine Journal
基金
河北省中医药管理局科研计划项目(2022227)。
