A COMPARISON OF CEREBRAL BLOOD-FLOW AND GLUCOSE-METABOLISM IN OLIVOPONTOCEREBELLAR ATROPHY USING PET
A COMPARISON OF CEREBRAL BLOOD-FLOW AND GLUCOSE-METABOLISM IN OLIVOPONTOCEREBELLAR ATROPHY USING PET
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DOI：
10.1212/wnl.45.7.1345
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发表时间：
1995-07-01
期刊：
影响因子：
9.9
通讯作者：
LOHMAN, M
中科院分区：
文献类型：
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作者：
GILMAN, S;STLAURENT, RT;LOHMAN, M
目的：探讨散发性橄榄桥小脑萎缩(OPCA)患者局部脑血流量(LCBF)是否减少，LCBF是否与脑局部葡萄糖代谢率(LCMRglc)相关，以及LCBF检测是否对OPCA有潜在的诊断价值。设计：对17例OPCa患者和21例正常对照组进行正电子发射断层扫描，用[O-15]H2O测定LCBF，用[F-18]氟代脱氧葡萄糖测定LCMRglc。结果：OPCA患者小脑LCBF显著降低，而大脑皮层、基底节、丘脑和脑干LCBF无明显变化。在同一患者中，变化最大的小脑和脑干以及大脑皮层、基底节和丘脑的lCMRglc显著降低。LCBF/lCMRglc是血流与代谢耦合的指标，在OPCA患者和正常人中，除脑干外，其余区域的LCBF/lCMRglc均相似，OPCA患者的LCBF/lCMRglc的比率略有下降。用Logistic判别分析来评价LCBF和lCMRglc对OPCa患者和正常人的鉴别能力，发现绝对lCMRglc作为OPCa预测指标的交叉验证敏感性为82%，相应的特异性为71%，绝对LCBF的敏感性为71%，特异性为76%。结论：在散发性OPCA病例中，小脑LCBF减少，CBF与LCMRglc相偶联，LCBF模式是一个有用的诊断指标。
Objective: In sporadic cases of olivopontocerebellar atrophy (OPCA), to determine whether local cerebral blood flow (lCBF) is reduced, whether lCBF is coupled to local cerebral metabolic rate for glucose (lCMRglc), and whether lCBF measurements are potentially useful in diagnosing OPCA. Design: Positron emission tomography was used with [O-15]H2O to measure lCBF and with [F-18]fluorodeoxyglucose to measure lCMRglc in 17 patients with OPCA and 21 normal control subjects. Results: In OPCA patients, lCBF was significantly decreased in the cerebellum, but not in the cerebral cortex, basal ganglia, thalamus, or brainstem. In the same patients, lCMRglc was significantly decreased in the cerebellum and brainstem, where the largest changes were observed, and also in the cerebral cortex, basal ganglia, and thalamus. The ratio of lCBF to lCMRglc, an indicator of the coupling of blood flow to metabolism, was similar in OPCA patients and normal subjects for all regions except the brainstem, where the ratio was marginally decreased in OPCA patients. Using logistic discriminant analysis to assess the ability of lCBF and lCMRglc to differentiate OPCA patients from normal subjects, we found the cross-validated sensitivity of absolute lCMRglc as a predictor of OPCA was 82% with a corresponding specificity of 71%; the sensitivity of absolute lCBF was 71% and the specificity 76%. Conclusions: In sporadic cases of OPCA, lCBF is reduced in the cerebellum, CBF remains coupled to lCMRglc, and the lCBF pattern is a useful predictor of the diagnosis.