摘要：
目的 探讨18F-脱氧葡萄糖（18F-FDG）PET 显像对慢性意识障碍患者预后的评价作用。方法 采用18F-FDG PET 观察20 例慢性意识障碍患者（包括无反应觉醒综合征/植物状态12 例、最低意识状态8例）大脑外在和内在感知网络区域葡萄糖代谢变化，计算各区域标准化摄取值（SUV）；并比较随访6 个月时意识恢复［Glasgow 预后分级-扩展版（GOS-E）> 2 级］与意识未恢复（GOS-E 分级≤ 2 级）患者各区域的葡萄糖摄取情况。结果 20 例患者6 个月随访时失访1 例、死亡9 例、意识未恢复2 例、意识恢复8例。意识未恢复组（意识未恢复+ 死亡）患者年龄高于意识恢复组（P = 0.001）；而昏迷恢复量表-修订版（CRS-R）评分（P = 0.030），以及双侧前额叶（左侧P = 0.000，右侧P = 0.002）、顶叶（左侧P = 0.003，右侧P =0.007）、楔前叶（左侧P = 0.000，右侧P = 0.003）、前扣带回（P = 0.001）、后扣带回（P = 0.006）SUV 值均低于意识恢复组。结论 18F-FDG PET 显像所示外在和内在感知网络区域葡萄糖代谢变化与慢性意识障碍患者预后相关，SUV 值越高、预后越佳。
关键词:
意识障碍,
正电子发射断层显像术,
预后
Abstract:
Objective To explore the role of 18F-fluoro-2-deoxy-D-glucose (18F-FDG) PET imaging for evaluation of the prognosis of patients with chronic disorders of consciousness. Methods 18F-FDG PET was performed to analyze glucose metabolism of external and internal awareness networks in 20 patients with chronic disorders of consciousness, and to calculate standardized uptake value (SUV) of each region. Compare the SUV of each region between conscious [Glasgow Outcome Scale-Extended (GOS-E) > 2] and unconscious (GOS-E ≤ 2) patients after 6 months follow-up. Results After 6 months, one case was lost, 8 cases recovered consciousness during the follow-up, 11 were unconscious (2 cases) or dead (9 cases). The age of unconscious or dead patients was significantly higher than that of conscious (P = 0.001), while the Coma Recovery Scale-Revised (CRS-R) score (P = 0.030) and the SUV of bilateral prefrontal lobes (left P = 0.000, right P = 0.002), bilateral parietal lobes (left P = 0.003, right P = 0.007), bilateral precuneus (left P = 0.000, right P = 0.003), anterior (P = 0.001) and posterior (P = 0.006) cingulate cortices of unconscious or dead patients were significantly lower than that of conscious patients. Conclusions The SUV of externaland internal awareness networks in 18F-FDG PET imaging is related to the prognosis of patients with chronic disorders of consciousness. The higher the SUV is, the better prognosis will be achieved.
Key words:
Consciousness disorders,
Positron-emission tomography,
Prognosis
张静, 全志永, 康晓刚, 高琼, 江文. 慢性意识障碍患者PET 显像的预后评价研究[J]. 中国现代神经疾病杂志, 2015, 15(12): 940-943.
ZHANG Jing, QUAN Zhi-yong, KANG Xiao-gang, GAO Qiong, JIANG Wen. The role of PET imaging in the evaluation of prognosis in patients with chronicdisorders of consciousness[J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2015, 15(12): 940-943.