新生儿缺氧缺血性脑病正电子发射断层脑显像测定脑-第三军医大学学报.doc

正电子发射断层显像测定新生儿缺氧缺血性脑病脑葡萄糖代谢的临床研究 史源1 金榕兵2 赵锦宁1 唐仕芳1 李华强1 李廷玉3 （第三军医大学附属大坪医院野战外科研究所1儿科，2核医学科，重庆 400042；3重庆医科大学附属儿童医院，重庆 400014） 基金项目：重庆市自然科学基金项目资助（CSTC，2004 BB5247） Supported by the National Foundation of Chongqing（CSTC，2004 BB5247） 作者简介：史源，男，教授、主任医师，硕士研究生导师，主要从事新生儿危重症的研究，电话：023 E-mail：petshi530@ 通信作者：金榕兵，E-mail: jinrbz@ 李廷玉，E-mail: tyli@ 摘要：目的 对新生儿缺氧缺血性脑病（HIE）患儿应用18氟脱氧葡萄糖（18F-FDG）正电子发射断层显像（PET）测定脑葡萄糖代谢，探讨PET测定脑葡萄糖代谢在新生儿HIE的临床应用价值。方法 选择健康足月新生儿9例、早产儿7例和新生儿HIE患儿8例，共24例，在注射0.1mCi /kg 18 F-FDG后应用PET测定脑葡萄糖代谢。结果 早产儿和健康足月新生儿脑18F-FDG PET显像，其葡萄糖代谢活性区主要在丘脑较高，在大脑皮层较低；在大脑皮层，足月新生儿摄取的葡萄糖活性较早产儿为高，结构较为清晰；新生儿HIE患儿脑存在明显葡萄糖代谢异常，主要表现为：大脑皮层18 F-FDG摄取量不一致，如损伤一侧明显低于对侧，或某区域低于其他区域；全脑偏低，尤其是皮层下白质、丘脑、基底节等部位最明显。结论 早产儿和健康足月新生儿脑18F-FDG PET 显像有自身特点，新生儿HIE患儿脑存在明显葡萄糖代谢异常，应用18F-FDG PET测定脑葡萄糖代谢为判断新生儿脑组织损伤程度提供了新的方法，其临床意义值得进一步研究。 关键词： PET；婴儿，新生；脑缺氧；脑缺血 SHI Yuan1, JIN Rong-bin2, Zhao Jin-ning1, TANG Shi-fang1, LI Hua-qiang1, LI Ting-yu3 (1Department of Pediatrics, 2Department of Nuclear Medicine, Daping Hospital and Research Institute of Surgery, Third Military Medical University, Chongqing 400042; 3Department of Child Health, Children’s Hospital of Chongqing Medical University, Chongqing 400014) Abstract: Objective To study the clinical value of cerebral glucose metabolism measure by 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) in neonatal hypoxic-ischemic encephalopathy (HIE). Methods To measure the cerebral glucose metabolism by 18F-FDG PET imaging in 9 term, 7 preterm newborn infants, and 8 neonates with HIE after administration of 0.1mCi /kg 18F-FDG. Results The brain 18F-FDG PET imaging showed that the uptake of 18F-FDG was relatively more in thalamus, and less in cerebral cortex in preterm and term newborn infants (P0.05). The uptake of 18F-FDG of cerebral cortex in preterm infants was less than that in term infants(P0.05), so the structure of brain 18F-FDG PET imaging was a little fainter in preterm neonates as compared with that in term newborns. The cereb