一体化18F-FDG PET/MR血流代谢显像评估慢性单侧头颈动脉狭窄

目的 观察一体化¹⁸F-PET/MR血流代谢显像评估单侧头颈动脉狭窄的价值。方法 纳入68例慢性单侧头颈动脉狭窄患者，记录其美国国立卫生研究院卒中量表（NIHSS）及改良Rankin量表（mRS）评分；采用一体化PET/MR同步采集MR结构像、动脉自旋标记图像和¹⁸F-FDG PET图像，基于血流、代谢图像获取并比较幕上病变侧血流减低区、代谢减低区、血流代谢同步减低区及其各项指标，分析其与临床神经功能评分的相关性。结果 68例患者中，与血流减低区比较血流代谢同步减低区脑血流量（CBF）更低（P<0.001）、不对称指数（AI）更高（P<0.001）；血流代谢同步减低区与代谢减低区标准摄取值比值（SUVR）差异无统计学意义（P=0.548），但前者AI更高（P<0.001）。同步减低区体积比与NIHSS、mRS均呈正相关（r_s=0.507、0.467，P均<0.001），SUVR AI与NIHSS、mRS均呈正相关（r_s=0.337、0.317，P均<0.05）。结论 一体化PET/MR可检出慢性单侧头颈动脉狭窄患者脑血流和脑葡萄糖代谢异常。

Integrated 18F-FDG PET/MR blood flow and metabolism imaging for evaluating chronic unilateral head and neck artery stenosis

Objective To explore the value of integrated ¹⁸F-FDG PET/MR blood flow and metabolism imaging in evaluating chronic unilateral head and neck artery stenosis. Methods Sixty-eight patients with chronic unilateral head and neck artery stenosis were enrolled, and the scale of National Institutes of Health stroke scale (NIHSS) and modified Rankin scale (mRS) were collected. MR structural images, arterial spin labeling (ASL) images and ¹⁸F-FDG PET image were obtained using hybrid PET/MR. Based on ASL and ¹⁸F-FDG PET images, parameters of the blood flow decreased region, metabolism decreased region and blood flow-metabolism co-decreased region were calculated and compared, and the correlations of these indexes and clinical neurological function scores were analyzed. Results Compared with those of blood flow decreased region, cerebral blood flow (CBF) decreased (P<0.001) and asymmetry index (AI) increased in blood flow-metabolism co-decreased region among 68 patients (P<0.001). The standard uptake value ratio (SUVR) of blood flow-metabolism co-decreased region and metabolism decreased region were not significantly different (P=0.548), while AI increased in blood flow-metabolism co-decreased region (P<0.001). The volume ratio of co-decreased region was positively correlated with NIHSS and mRS (r_s=0.507, 0.467, both P<0.001), while SUVR AI of co-decreased region was positively correlated with NIHSS and mRS (r_s=0.337, 0.317, both P<0.05). Conclusion Integrated ¹⁸F-FDG PET/MR could detect abnormal cerebral blood flow and cerebral glucose metabolism in patients with chronic unilateral head and neck artery stenosis.