血管性痴呆患者认知功能与脑代谢研究
广东省人民医院神经科 (510010)
广东省人民医院核医学科 (510010)
【摘要】目的：探讨血管性痴呆(VD)认知功能与脑代谢的关系，探索VD认知障碍的机制。
方法：1.研究对象：(1)VD组：13例，男性7例，女性6例，年龄60～88岁。(2)正常对照组：13人，男性7人，女性6人，年龄60～87岁。2.认知功能评定：简易精神状态检查法(MMSE)，韦氏成人智力量表(WAIS-RC)。3. 18F-脱氧葡萄糖正电子发射计算机断层扫描(18F-FDG PET)PET显像及半定量分析：在双侧顶叶、颞叶、额叶、枕叶、海马和小脑框取感性趣区(ROI)，并获单位面积放射性计数与小脑计数的比值作为半定量指标。4.与MRI对照分析。
结果：1.正常影像特征：正常脑PET显像可见大脑各叶、海马、基底节、丘脑、中脑及小脑放射性分布均匀对称，其中3例老年人的脑皮质沟回加深、脑沟增宽，提示有轻度脑萎缩表现。2. VD的PET显像特征：皮层及皮层下结构、单侧或双侧非对称性多发性放射性减低、代谢减低；病灶涉及单个或多个脑叶；脑代谢下降与脑梗死灶部位一致。2. PET半定量分析与VD认知功能障碍的分析：(1)VD认知功能障碍与病变范围及脑代谢下降程度相关，重者累及各脑叶皮层及皮层下结构，轻者病变范围较小，多限于脑叶局部；(2)VD的操作能力及言语能力与代谢下降部位显著相关；皮层代谢下降者，言语能力受损明显，皮层下结构基底节代谢下降者，操作智商受损明显。结论：VD认知功能障碍与脑代谢降低的程度及部位有关，PET显像对VD患者脑功能评估有重要价值。
, 百拇医药
The correlative study on glucose metabolism of the brain using 18F-FDG PET and cognition in Patients with Vesculer Dementia
WANG Lijuan , ZHAO Jiehao , ZHOU Xiaohong , et al.
Department of neurology, Guangdong provincial people’s hospital, Guangzhou, China
【Abstract】Objective: To study the correlation between the images of 18 F-FDG PET of the brain and cognition in Patients with Vasculer Dementia (VD). Method: 13 patients with VD and 13 age-, sex- and education-matched normal controls (NC) were studied. 18F-FDG PET brain scan was performed in all the patients and controls, Wechsler Adult Intelligence Scale-Revised in China (WAIS-RC), Mini Mental Status Examination (MMSE) was adopted to examine all the patients and controls. 13 VD patients and 13 controls were examined by the magnetic resonance imaging (MRI). Result: 100% of PD patients showed abnormal PET images. The Rcl/cb of cerebral lobes and basal ganglion in VD patients was significantly decreased than in NC. There were correlation between the extent of cognitive disturbance and the degree and range of decreasing of glucose metabolism in Vasculer Dementia. The metabolism decreased almost on the local of cerebral lobes in mild cases of VD patients, but it might be decreased either on the cortical and subcortical of cerebral lobs in serious cases of VD. The scores of PIQ, VIQ, FIQ and MMSE in VD patients were less then that in the normal controls, P<0.01. VIQ was less than PIQ in VD patients which more decreasing of glucose metabolism in cortical but PIQ was less then VIQ in which more decreasing of glucose metabolism in subcortical and basal ganglion. Conclusion: VD patients had cognitive disturbance. It might be correlation to the degree and range of cerebral lodes metabolism damage. PET was helpful to assess the cognition and metabolism of brain. It was effective means for
detecting thecerebral functional impairment of VD, 百拇医药(王丽娟 赵洁浩 周晓红 王硕 詹培源 郑芷萍 刘新通 黄智恒 詹国华 唐安戊 乔穗宪)
广东省人民医院核医学科 (510010)
【摘要】目的：探讨血管性痴呆(VD)认知功能与脑代谢的关系，探索VD认知障碍的机制。
方法：1.研究对象：(1)VD组：13例，男性7例，女性6例，年龄60～88岁。(2)正常对照组：13人，男性7人，女性6人，年龄60～87岁。2.认知功能评定：简易精神状态检查法(MMSE)，韦氏成人智力量表(WAIS-RC)。3. 18F-脱氧葡萄糖正电子发射计算机断层扫描(18F-FDG PET)PET显像及半定量分析：在双侧顶叶、颞叶、额叶、枕叶、海马和小脑框取感性趣区(ROI)，并获单位面积放射性计数与小脑计数的比值作为半定量指标。4.与MRI对照分析。
结果：1.正常影像特征：正常脑PET显像可见大脑各叶、海马、基底节、丘脑、中脑及小脑放射性分布均匀对称，其中3例老年人的脑皮质沟回加深、脑沟增宽，提示有轻度脑萎缩表现。2. VD的PET显像特征：皮层及皮层下结构、单侧或双侧非对称性多发性放射性减低、代谢减低；病灶涉及单个或多个脑叶；脑代谢下降与脑梗死灶部位一致。2. PET半定量分析与VD认知功能障碍的分析：(1)VD认知功能障碍与病变范围及脑代谢下降程度相关，重者累及各脑叶皮层及皮层下结构，轻者病变范围较小，多限于脑叶局部；(2)VD的操作能力及言语能力与代谢下降部位显著相关；皮层代谢下降者，言语能力受损明显，皮层下结构基底节代谢下降者，操作智商受损明显。结论：VD认知功能障碍与脑代谢降低的程度及部位有关，PET显像对VD患者脑功能评估有重要价值。
, 百拇医药
The correlative study on glucose metabolism of the brain using 18F-FDG PET and cognition in Patients with Vesculer Dementia
WANG Lijuan , ZHAO Jiehao , ZHOU Xiaohong , et al.
Department of neurology, Guangdong provincial people’s hospital, Guangzhou, China
【Abstract】Objective: To study the correlation between the images of 18 F-FDG PET of the brain and cognition in Patients with Vasculer Dementia (VD). Method: 13 patients with VD and 13 age-, sex- and education-matched normal controls (NC) were studied. 18F-FDG PET brain scan was performed in all the patients and controls, Wechsler Adult Intelligence Scale-Revised in China (WAIS-RC), Mini Mental Status Examination (MMSE) was adopted to examine all the patients and controls. 13 VD patients and 13 controls were examined by the magnetic resonance imaging (MRI). Result: 100% of PD patients showed abnormal PET images. The Rcl/cb of cerebral lobes and basal ganglion in VD patients was significantly decreased than in NC. There were correlation between the extent of cognitive disturbance and the degree and range of decreasing of glucose metabolism in Vasculer Dementia. The metabolism decreased almost on the local of cerebral lobes in mild cases of VD patients, but it might be decreased either on the cortical and subcortical of cerebral lobs in serious cases of VD. The scores of PIQ, VIQ, FIQ and MMSE in VD patients were less then that in the normal controls, P<0.01. VIQ was less than PIQ in VD patients which more decreasing of glucose metabolism in cortical but PIQ was less then VIQ in which more decreasing of glucose metabolism in subcortical and basal ganglion. Conclusion: VD patients had cognitive disturbance. It might be correlation to the degree and range of cerebral lodes metabolism damage. PET was helpful to assess the cognition and metabolism of brain. It was effective means for
detecting thecerebral functional impairment of VD, 百拇医药(王丽娟 赵洁浩 周晓红 王硕 詹培源 郑芷萍 刘新通 黄智恒 詹国华 唐安戊 乔穗宪)