摘要：

目的 探讨多模态分子影像学技术在路易体痴呆诊断中的应用价值。方法 共5 例可能的路易体痴呆患者，进行详细的临床病史采集、神经心理学测验、头部MRI 检查，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）和¹⁸F-脱氧葡萄糖（¹⁸F-FDG）PET 显像。结果 路易体痴呆患者早期认知功能障碍和幻视较为明显。¹¹C-β-CFT PET 可见双侧壳核和尾状核多巴胺转运体摄取降低；¹¹C-PIB PET 可见双侧额颞顶枕叶皮质弥漫性淀粉样蛋白摄取升高；¹⁸F-FDG PET 可见双侧顶枕叶葡萄糖代谢降低。结论 多模态分子影像学技术可以显著提高路易体痴呆临床诊断的特异性，有望实现生前明确诊断。

关键词: Lewy体病, 痴呆, 正电子发射断层显像术

Abstract:

Objective To evaluate the value of multimodal molecular imaging in the diagnosis of dementia with Lewy bodies (DLB). Methods Five patients with probable DLB received detailed clinical data collection, neuropsychological tests, head MRI examination, ¹¹C-methyl-N-2β-carbomethoxy-3β-(4-fluorophenyl)-tropane (¹¹C-β-CFT) PET, ¹¹C-Pittsburgh compound B (¹¹C-PIB) PET and ¹⁸F-fluoro-2-deoxy-D-glucose (¹⁸F-FDG) PET examination. Results Cognitive dysfunction and visual hallucinations were prominent symptoms in patients with DLB. ¹¹C-β-CFT PET showed that the radioactive uptake significantly reduced in bilateral putamen and caudate nuclei. ¹¹C-PIB PET showed increased radioactive retention in bilateral frontal, temporal, parietal and occipital cortex with various degrees. ¹⁸F-FDG PET showed glucose hypometabolism in bilateral parietal and occipital cortex. Conclusions Multimodal molecular imaging greatly improves the specificity of clinical diagnosis of DLB, and it is expected to achieve accurate diagnosis before death.

Key words: Lewy body disease, Dementia, Positron-emission tomography

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