摘要
尽管已知的明确的临床标准,但是额颞叶痴呆(FTD)亚型临床症状的明显重叠却存在于数种病例中,导致诊断界限的高度不确定性。我们采用99mTc-HMPAO SPECT Brodmann分区(BA)映射脑灌注成像来评估FTD亚型间的灌注。NeuroGamTM 软件应用于BA灌注半定量评估及软件正常数据库比较的单光子发射计算机体层摄影术(SPECT)研究。我们研究了91位连续就诊的FTD病人:21位行为异常(bvFTD),39位语言变体(lvFTD) [12位非流利性失语(PNFA),27位语义性痴呆(SD)]及31位进行性核上性麻痹(PSP)/ 皮质基底核退化症(CBD)。逐步逻辑回归分析表明BA 28L 和32R分区能够独立区分bvFTD 与lvFTD患者,而BA 8R 和25R分区能够分别将FTD 患者与SD 和PNFA患者区分。 此外发现BA 7R和32R区可以辨别bvFTD 与CBD/PSP 患者。BA分区中只有6L区可以区分SD与PNFA患者。发现BA 6R和20L区可以各自区分 CBD/PSP 与lvFTD患者。 而且BA 20L 和22R区可以区分CBD/PSP与PNFA患者,而发现BA 6R、20L 及45R区可以分别区分CBD/PSP 与SD患者。BA映射SPECT 脑灌注成像是一种有用的额外方法,通过完善特别有影响的大脑区域定义以区分FTD变体,从而导致一种更准确的鉴别诊断非典型或不确定形式的FTD的方法。
关键词: 脑灌注成像,布洛德曼区,额颞痴呆,SPECT
Current Alzheimer Research
Title:Brain Perfusion SPECT with Brodmann Areas Analysis in Differentiating Frontotemporal Dementia Subtypes
Volume: 11 Issue: 10
Author(s): Varvara Valotassiou, John Papatriantafyllou, Nikolaos Sifakis, Chara Tzavara, Ioannis Tsougos, Dimitrios Psimadas, Eftychia Kapsalaki, Ioannis Fezoulidis, George Hadjigeorgiou and Panagiotis Georgoulias
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关键词: 脑灌注成像,布洛德曼区,额颞痴呆,SPECT
摘要: Despite the known validity of clinical diagnostic criteria, significant overlap of clinical symptoms between Frontotemporal dementia (FTD) subtypes exists in several cases, resulting in great uncertainty of the diagnostic boundaries. We evaluated the perfusion between FTD subtypes using brain perfusion 99mTc-HMPAO SPECT with Brodmann areas (BA) mapping. NeuroGamTM software was applied on single photon emission computed tomographic (SPECT) studies for the semi-quantitative evaluation of perfusion in BA and the comparison with the software’s normal database. We studied 91 consecutive FTD patients: 21 with behavioural variants (bvFTD), 39 with language variants (lvFTD) [12 with progressive non-fluent aphasia (PNFA), 27 with semantic dementia (SD)], and 31 patients with progressive supranuclear palsy (PSP)/corticobasal degeneration (CBD). Stepwise logistic regression analyses showed that the BA 28L and 32R could independently differentiate bvFTD from lvFTD, while the BA 8R and 25R could discriminate bvFTD from SD and PNFA, respectively. Additionally, BA 7R and 32R were found to discriminate bvFTD from CBD/PSP. The only BA that could differentiate SD from PNFA was 6L. BA 6R and 20L were found to independently differentiate CBD/PSP from lvFTD. Moreover, BA 20L and 22R could discriminate CBD/PSP from PNFA, while BA 6R, 20L and 45R were found to independently discriminate CBD/PSP from SD. Brain perfusion SPECT with BA mapping can be a useful additional tool in differentiating FTD variants by improving the definition of brain areas that are specifically implicated, resulting in a more accurate differential diagnosis in atypical or uncertain forms of FTD.
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Varvara Valotassiou, John Papatriantafyllou, Nikolaos Sifakis, Chara Tzavara, Ioannis Tsougos , Dimitrios Psimadas, Eftychia Kapsalaki, Ioannis Fezoulidis, George Hadjigeorgiou and Georgoulias Panagiotis, Brain Perfusion SPECT with Brodmann Areas Analysis in Differentiating Frontotemporal Dementia Subtypes, Current Alzheimer Research 2014; 11 (10) . https://dx.doi.org/10.2174/1567205011666141107125104
DOI https://dx.doi.org/10.2174/1567205011666141107125104 |
Print ISSN 1567-2050 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-5828 |
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