Objective:To investigate the value of 18F-FDG positron emission tomography/computed tomography (PET/CT) two time point imaging for the identification of the potential epileptogenic zone (EZ) in temporal lobe epilepsy (TLE).Methods:Fifty-two patients with TLE were prospectively enrolled in the 18F-FDG PET/CT two time point imaging study. The early imaging was obtained approximately 40 min (43.44 ± 18.04 min) after 18F-FDG injection, and the delayed imaging was obtained about 2 to 3 h (160.46 ± 28.70 min) after the injection. Visual and semi-quantitative analysis of 18F-FDG uptake were performed at the two time points in EZ and contralateral symmetrical region. The mean standardized uptake value (SUVmean) of EZ and contralateral symmetrical region was calculated to determine the asymmetry index (AI) of the early and delayed images, as well as in the MRI positive and negative patient groups.Results:Semi-quantitative analysis demonstrated that AI of the early and delayed 18F-FDG PET/CT images was 13.47 ± 6.10 and 16.43 ± 6.66, respectively. The ΔAI was 2.95 ± 3.05 in 52 TLE patients between the two time points. The AI of the EZ was significantly elevated in delayed images compared to the early images (p < 0.001). The AI of delayed imaging was also significantly elevated compared to the early imaging in both MRI positive (ΔAI = 2.81 ± 2.54, p < 0.001) and MRI negative (ΔAI = 3.21 ± 3.91, p < 0.003) groups, and more pronounced in MRI negative group. Visual analysis also showed that the delayed imaging appeared to be superior to the early imaging for identification of potential EZ.Conclusion:Delayed 18F-FDG PET imaging provided significantly better than the early imaging in the identification of potential EZ, which can be valuable during epilepsy pre-surgical evaluation in patients with TLE.

目的:分析布鲁菌病患者 18F-氟代脱氧葡萄糖正电子发射计算机断层成像( 18F-fluorodeoxyglucose positron emission tomography-computed tomography， 18F-FDG PET-CT)检查的表现特点及其应用价值。 方法:纳入2012年12月至2022年5月河南省人民医院和河南省胸科医院确诊的15例布鲁菌病患者。回顾性分析患者的临床资料，并观察全身各组织器官 18F-FDG PET-CT表现，测量各特定部位病变区的病灶大小、形态、密度及氟代脱氧葡萄糖(fluorodeoxyglucose，FDG)的最大标准摄取值，将最大标准摄取值≥肝脏FDG摄取值视为阳性摄取。 结果:15例布鲁菌病患者的年龄范围为28~64岁，7例有牛羊接触史或食用过牛羊肉，3例有疫区生活史，既往均无肝炎、肝硬化及肝脏肿瘤等病史。临床呈急性或亚急性起病，主要表现为发热、多汗、无力，5例有腰痛，2例有咳嗽、胸闷，病程为15 d至2个月。所有患者 18F-FDG PET-CT检查均发现全身多脏器受累改变，11例患者的躯干骨髓腔和6例患者的脾脏呈轻度弥漫性阳性摄取，5例患者的胸部或腰椎、8例的肝脏、3例的肺部、3例的前列腺、1例的附睾、1例的脾脏、2例的脊髓、8例的多发淋巴结、1例的腰大肌、1例的股骨头韧带分别可见局灶性FDG摄取值增高。 结论:18F-FDG PET-CT检查可见布鲁菌病患者全身骨关节及软组织脏器感染播散状态，尤其对检出脊柱外脏器组织病变具有优势。

Objective:To investigate changes in resting glucose metabolism in the brain of patients with anemia of different degrees.Methods:The brain 18F-fluorodeoxyglucose (FDG) PET/CT imaging data of 51 patients who were clinically diagnosed with anemia in People's Hospital of Zhengzhou University from December 2016 to April 2019 were retrospectively analyzed. The study population included 16 males and 35 females aged 21-60 (41.13±9.78) years. According to the diagnostic criteria of anemia in WHO and relevant literature, the patients were divided into 3 groups: mild anemia (90 g/L-lower limits of normal), moderate anemia (60-90 g/L) and severe anemia (30-60 g/L). A total of 56 healthy physical examiners were recruited as controls; this group included 29 males and 27 females aged 19-58 (41.96±9.27) years. Statistical Parametric Mapping 8 software was used to process and analyze the PET images of anemia group and healthy controls. The brain PET images of all anemia groups and the control group were tested by voxel-to-voxel two-sample t-test to obtain difference distribution maps of brain PET metabolism between each group. XjView software was used to conduct stereotaxic and quantitative analyses of voxel values in brain regions reflecting statistical differences. The t values of all abnormal regions were obtained. Results:Compared with those in the control group, hypometabolic brain areas in patients with anemia were mainly distributed in the bilateral superior, middle, and inferior frontal gyri; the right inferior temporal gyri; and the right inferior parietal lobule gyri, the total voxel value was 3705 ( t=5.01-5.85, all P<0.05). Hypermetabolic areas were not observed in anemia patients. Compared with that in the mild group, hypometabolism in the moderate group was observed in the bilateral inferior frontal, right middle frontal, right inferior temporal gyri, and the right inferior parietal lobule gyri, the total voxel value was 832 ( t=5.22-5.86, all P<0.05). Hypometabolism in the severe group was observed in the bilateral superior frontal, bilateral middle-inferior frontal, right inferior temporal, and right inferior parietal lobule gyri, the total voxel value was 1834 ( t=5.42-6.05, all P<0.05). Compared with that in the moderate group, hypometabolism in the severe group was noted in the left superior frontal, left middle-inferior frontal, and right middle frontal gyri, right inferior temporal lobe, and right inferior parietal lobule gyri, the total voxel value was 1598 ( t=5.72-6.48, all P<0.05). Conclusions:Patients with anemia showed relative reductions in regional cerebral resting glucose metabolism. The cerebral regions demonstrating reduced metabolism were mainly related to emotion cognition. As anemia progressed, areas reflecting a decrease in cerebral metabolism increased.

目的 探讨18F-脱氧葡萄糖(18F-fluorodeoxyglucose,18F-FDG)正电子发射计算机断层扫描(positron emission tomography/computed tomography,PET/CT)联合功能磁共振成像(function magnetic resonance imaging,fMRI)在原发性中枢神经系统淋巴瘤(primary central nervous system lymphoma,PCNSL)中的诊断价值.方法 回顾性分析17例PCNSL患者PET/CT影像学特征[最大标准摄取值(standard uptake value maximum,SUVmax),平均标准摄取值(standard uptake value maximum mean,SUVmean)]及其中10例患者功能磁共振影像学特征[磁共振扩散加权成像(diffusion weighted imaging,DWI),磁共振灌注成像(perfusion weighted imaging,PWI)],同时统计14例Ⅲ～Ⅵ级胶质瘤和14例脑转移瘤患者PET/CT影像学特征(SUVmax、SUVmean),绘制PCNSL组与脑胶质瘤、转移瘤联合组的SUVmax及SUVmean受试者工作特征曲线(receiver operator characteristic curve,ROC),确定诊断最优阈值,观察10例原发性中枢神经系统淋巴瘤患者ADC病灶平均值与SUVmax及SUVmean的相关性.结果 17例淋巴瘤组共28个病灶,10例具有MRI影像资料患者,共15个病灶.淋巴瘤组与胶质瘤、转移瘤联合组SUVmax(t=0)、SUVmean(t=0)差异有统计学意义.根据ROC曲线分析,SUVmax曲线下面积AUC:0.836,取截断值SUVmax为17.55时,敏感性0.765,特异性0.821;SUVmean曲线下面积AUC:0.853,取截断值SUVmean为11.9时,敏感性0.882,特异性0.75.10例具有MRI影像资料的PCNSL患者,病灶PWI呈低灌注13例,等灌注2例,DWI弥散受限,且平均ADC值与SUVmax(r=—0.725,P=0.018)及SUVmean(r=—0.666,P=0.036)呈负相关.结论 原发性中枢神经系统淋巴瘤18F-FDG PET/CT摄取程度高于胶质瘤组和转移瘤组,且SUVmax 17.55和SUVmean 11.9可作为参考诊断阈值,指导淋巴瘤与其他颅内常见肿瘤(胶质瘤和转移瘤)的鉴别,结合其功能MRI弥散受限及灌注减低等特点更有助于提高PCNSL诊断特异性.

Objective:To prepare 68Ga-2-(4, 7-bis(carboxymethyl)-1, 4, 7-triazonan-1-yl)pentanedioic acid (NODAGA)-YHWYGYTPQNVI (GE11) and evaluate its feasibility of PET imaging for pancreatic cancer. Methods:GE11 peptide was conjugated with NODAGA and then labeled with 68Ga. The labeling yield, radiochemical purity, hydrophilicity, stability and specificity in vitro were determined. Human pancreatic cancer BxPC3 nude mice models ( n=9) were established. MicroPET imaging was then obtained after 30 and 90 min, and mice were sacrificed at 90 min to acquire the radioactivity distribution of main organs and tumors. Pair t test was used to analyze the data. Results:The labeling yield was (73.5±5.4)% and radiochemical purity was more than 98%. After incubation 120 min in mouse serum at 37 ℃, radiochemical purity was more than 92%. The uptake was specific in BxPC3 cell lines. MicroPET images showed that 68Ga-NODAGA-GE11 could accumulate quickly in tumor. Value of tumor uptake was significantly higher than that of normal pancreas at 90 min ((1.38±0.25) vs (0.49±0.07) %ID/g; t=12.67, P<0.05), and the radio-uptake of blood, muscle and bone was lower than that of tumor. Conclusions:68Ga-NODAGA-GE11 is easy to be prepared with high radiochemical purity and good stability, and can specifically target BxPC3 xenograft tumor. However, due to the high uptake in the kidneys and liver, the value of 68Ga-NODAGA-GE11 in PET imaging for pancreatic tumor needs further study.

Objective:To investigate the clinicopathological characteristics and 18F-fluorodeoxyglucose (FDG) PET/CT imaging features of bronchopulmonary neuroendocrine tumors(BP-NETs) with different pathological subtypes. Methods:From January 2013 to May 2018, 280 patients (196 males, 84 females, median age 58 years) with BP-NETs proved by pathology in Henan Provincial People′s Hospital were retrospectively analyzed. Age, gender, smoking history, the location and size of tumor, Ki-67 positive index, thyroid transcription factor-1 (TTF-1), synaptophysin (Syn), chromogranin-A (CgA), CD56, maximum standardized uptake value (SUV max), lymph node metastasis and distant metastasis were compared among 4 pathological subtypes of BP-NETs, including typical carcinoid (TC), atypical carcinoid (AC), small cell lung carcinoma (SCLC) and large cell neuroendocrine carcinoma (LCNEC). One-way analysis of variance, χ2 test, Fisher exact test and Kruskal-Wallis rank sum test were used for data analysis. Results:There were significant differences in age, smoking history, tumor size and location, Ki-67 positive index, CgA, CD56, TTF-1, SUV max and TNM stage among TC( n=59), AC( n=21), SCLC( n=184) and LCNEC ( n=16) groups ( F values: 2.067, 3.358, H values: 17.749-22.351, all P<0.05). SCLC had the largest tumor size (5.5(3.0, 6.8) cm) and the highest proportion of central type (85.3%, 157/184), and were more prone to lymph node metastasis. LCNEC had the oldest age ((66±16) years), the largest proportion of smoking history (14/16) and peripheral type (12/16). CD56 in SCLC (95.7%, 176/184) and LCNEC(15/16) mostly showed positive expression, while the positive expression rates of CgA and TTF-1 were higher in TC and AC (96.6%(57/59), 93.2%(55/59) and 95.2%(20/21), 90.5%(19/21), respectively). The Ki-67 positive index and SUV max of the four subtypes were significantly different, with the highest in SCLC group and the lowest in TC group. Conclusion:Different pathological subtypes of BP-NETs manifest different clinicopathological features and imaging presentation on 18F-FDG PET/CT, which are useful for understanding their characteristics.

Objective:To study the correlation between changes of cerebral striatal dopamine D 2 receptors non-displaceable binding potential (BP ND), functional connectivity (FC) and clinical symptoms in patients with first-episode major depressive disorder (MDD), by 11C-Raclopride PET/CT and resting state fMRI (rs-fMRI). Methods:Thirty-eight first-episode depression patients (MDD group) and forty healthy volunteers (control group) matched with age, gender and years of education were selected. All subjects were scored with Hamilton depression scale (24 versions) before enrollment.All the subjects underwent cerebral 11C-Raclopride PET/CT and rs-fMRI in resting state. MIAKAT and DPARSF were used to analyze BP ND of cerebral striatal dopamine D 2 receptors and FC of striatum and the whole brain in subjects, respectively. Changes of striatal dopamine D 2 receptors BP ND and striatum and the whole brain FC of MDD were analyzed, and correlations among BP ND, FC and Hamilton depression rating scale were calculated by Rest 1.8 and SPSS 20.0. Results:Compared with the control group, BP ND of bilateral caudate nucleus and putamen dopamine D 2 receptors in the MDD group were decreased(left caudate nucleus: 1.16±0.37 vs 1.48±0.39, right caudate nucleus: 1.21±0.31 vs 1.62±0.48, left putamen: 1.73±0.47 vs 2.21±0.66, right putamen: 1.79±0.46 vs 2.17±0.65, t=3.66, -4.42, -3.68, -2.91, all P<0.001). Besides, FC of left caudate nucleus and left medial prefrontal lobes(4.38±1.31, 2.35±0.48), left caudate nucleus and left middle frontal gyrus(3.36±1.11, 1.64±0.56), left caudate nucleus and left superior frontal gyrus(3.14±0.78, 1.64±0.53), left putamen and left medial prefrontal lobes(4.10±1.42, 2.42±0.64, t=6.82, P<0.05), right caudate nucleus and right medial prefrontal lobes (4.32±1.30, 2.33±0.63, t=8.51, P<0.05), right putamen and right medial prefrontal lobes(3.77±1.25, 2.31±0.63, t=6.49, P<0.05)in the MDD group were increased.FC of left putamen and left anterior cingulate(1.60±0.55, 2.68±0.84, t=-6.76, P<0.05), right caudate nucleus and right amygdala (1.67±0.57, 3.46±0.64, t=-8.27, P<0.05) in the MDD group were decreased. Furthermore, there were significant negative correlations between D 2 receptors BP ND of bilateral striatum and FC of the same lateral striatum and medial prefrontal lobes ( r=-0.66, -0.50, -0.67, -0.47, all P<0.05). In MDD group, FC in left caudate nucleus and left medial prefrontal lobe were positively correlated with total score of Hamilton depression scale and anxiety somatization( r=0.55, 0.68, P<0.001). FC in left putamen and left medial prefrontal cortex were positively correlated with cognitive impairment and retardation ( r=0.37, 0.40, P=0.021, 0.001). FC of right caudate nucleus and right medial prefrontal lobe were positively correlated with Hamilton depression scale total score and anxiety somatization ( r=0.52, 0.67, all P<0.001). FC in right putamen and right medial prefrontal cortex was positively correlated with cognitive impairment ( r=0.50, P=0.002). Conclusion:The abnormal BP ND of cerebral striatal dopamine D 2 receptor of patients with first-episode depression is related to the abnormal activity of dopamine reward circuit related neurons in patients with MDD, which was related to clinical symptoms of depression. It may be involved in the pathogenesis of depression.

Objective To study the imaging features of 18F-fluorodeoxyglucose(FDG) PET/CT in patients with autoimmune encephalitis (AE) and evaluate the value of PET/CT on early diagnosis of AE.Methods Sixteen patients with AE (11 males,5 females,age:11-68 years) between March 2012 and December 2017 were included.Patients had positive antibodies in cerebrospinal fluid or (and) serum without immunity therapy.The imaging (18F-FDG PET/CT,MRI) and clinical data were analyzed.Results Nine patients suffered from anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis and other 7 patients had limbic encephalitis (LE),which including 2 cases of anti-leucine-rich glioma inactivated 1 (LGI1) encephalitis,3 cases of anti-γ-aminobutyric acid-B receptor(GABAsR) encephalitis,1 case of anti-Hu encephalitis and 1 case of anti-Yo encephalitis.Fifteen patients showed scattered hypermetabolism or hypometabolism in the brain on PET/CT imaging,and the positive rate was 15/16.Among those patients with anti-NMDAR encephalitis,hypermetabolism in frontotemporal parietal lobes and hypometabolism in occipital lobe were shown;hypermetabolism in limbic systems including temporal lobe and hippocampus were shown in LE.No abnormal CT density was found at the same phase.Slightly higher signals on T2,fluid-attenuated inversion recovery (FLAIR) and diffusion weighted imaging (DWI) were detected in some patients,and the positive rate was 7/16.Conclusions Patients with AE of different types have different characteristics on 18F-FDG PET/CT.18F-FDG PET/CT has high positive rate for early diagnosis of AE.

Objective To explore the changes of dopamine D2 receptor in dopamine pathway in in-somnia patients and discuss its clinical significance. Methods From January 2016 to December 2016, 15 patients with insomnia (1 male, 14 females, age:(44.3±8.6) years) and 15 gender-/age-matched-healthy volunteers (control group;3 males, 12 females, age:(40.5±9.0) years) were included to undergo resting brain 11C-Raclopride PET/CT imaging. The D2 receptor binding potential (BPND) of the dopamine pathway was calculated by molecular imaging and kinetic analysis toolbox ( MIAKAT) software. The BP ND , Hamilton depression scale ( HAMD) , transient and graphics memory scale results were compared with two-sample t test and Mann-Whitney u test between the two groups. Pearson correlation analysis was used to evaluate the correlation between BPND(nucleus accumbens, caudate nucleus, putamen) and Pittsburgh sleep quality in-dex ( PSQI) , HAMD, course of disease, transient memory and graphical memory scale scores in the patient group. Results The BP ND in bilateral putamen, nucleus accumbens and left caudate nucleus of patients was lower than that of controls( left putamen:z=-2.717, right putamen:z=-2.883, both P<0.01;left nu-cleus accumbens:t=-2.269, right nucleus accumbens:t=-2.410, both P<0.05;left caudate nucleus:t=-2.632,P<0. 05), but the BPND level of right caudate nucleus was not significantly different(z=-0.850, P>0.05) . The scores of HAMD in the patient group were higher than those in control group ( t=10. 273, P<0. 01), while the scores of instantaneous memory (t=-4.888, P<0.01) and graphical memory scale (t=-2.624, P<0.05) were lower. There were significant negative correlations between the BP ND of bilateral nucleus ac-cumbens, caudate nucleus and putamen and the course of insomnia in the patient group ( r range:-0.761 to-0.682, all P<0.01) . Conclusion Patients with insomnia have abnormal neurotransmitter system of dopa-mine D2 and it may play a role in the pathogenesis of insomnia.

目的 探讨伴快速眼动睡眠期行为障碍的帕金森(Parkinson disease with REM sleep behavior disorder,PD-RBD)患者认知功能以及其蓝斑下核与各脑区的功能连接.方法 纳入PD-RBD患者20例,不伴快速眼动睡眠期行为障碍的帕金森(Parkinson disease with no REM sleep behavior disorder,PD-nRBD)患者23例和正常对照者(normal control,NC)21名进行认知功能评估,并对三组行静息态功能磁共振扫描,比较双侧蓝斑下核与各脑区的功能连接.结果 PD-RBD组DOT-A(P=0.004)、SDMT(P<0.001)、SCWTB(P=0.001)、SCWT C(P=0.013)、AVLT N1(P<0.001),N2(P<0.001),N3(P<0.001),N4(P<0.001),N5(P=0.003),N6(P=0.004)和PD-nRBD组DOT-A(P=0.011)、SDMT(P<0.001)、SCWTB(P=0.007)、SCWT C(P=0.011)、AVLT N1(P<0.001),N2(P<0.001),N3(P<0.001),N4(P=0.003),N5(P=0.011),N6(P=0.002)评分低于对照组且有统计学差异.与NC组相比,PD-RBD组双侧蓝斑下核分别与双侧楔前叶、 双侧小脑的功能连接均减弱,PD-nRBD组右侧蓝斑下核与双侧小脑连接增强;PD-RBD组左侧蓝斑下核与左侧楔前叶功能连接强度与ROCFT临摹部分得分呈显著正相关(r=0.507,P=0.038),右侧蓝斑下核与右侧楔前叶功能连接强度与SCWTC、ROCFT临摹部分得分呈显著正相关(r=0.501,P=0.041;r=0.628,P=0.007).结论 PD-RBD和PD-nRBD患者均存在注意力/执行力及记忆力损害,但仅PD-RBD患者蓝斑下核与认知相关脑区出现功能连接异常,并参与引起PD-RBD患者注意力和视空间能力的下降.

Objective To investigate the abnormal functional connectivity (FC) between the cores (including sublaterodorsal nucleus (SLD) and ventrolateral periaqueductal gray matter (vlPAG)) and the whole brain in rapid eye movement sleep behavior disorder (RBD) by resting state functional magnetic resonance imaging (rfMRI).Methods A total of 41 subjects recruited in the Department of Neurology,the People's Hospital of Zhengzhou University were enrolled in this study according to international diagnosis criteria,including 20 with idiopathic RBD (iRBD group) and 21 age,sex-matched normal controls (control group).All subjects were examined by Hoehn-Yahr Staging,cognitive tests and rfMRI.Resluts HoehnYahr staging score was 0(0,0) in the iRBD group,which showed no significant difference from that in the control group (0 (0,0),Z =-1.820,P =0.069).The scores of Rey Auditory Verbal Learning Test (AVLT) N1,AVLT N2,Symbol Digital Modalities Test,Rey-Osterrieth Complex Figure Test-Copy were 3.80 ± 1.67,5.10 ± 1.77,33.00(31.25,34.00) and 22.00(20.25,26.00) respectively in the iRBD group,which were significantly lower than that in the control group (4.95 ± 1.28,t =2.482,P =0.017;6.43±1.16,t =2.848,P=0.007;33.00(29.50,35.50),Z=-3.792,P=0.000;35.00(33.00,36.00),Z =-2.351,P =0.019) respectively.The scores of Trail Making Test 1 (86.5 (70.0,100.0))and Trail Making Test 2 (197.0(180.5,211.5)) in the iRBD group were significantly higher than that in the control group (66.0(49.0,91.5),112.0(99.5,173.0) respectively,Z=-2.373,P=0.018;Z =-3.105,P =0.002).Compared with the control group,the FC analysis showed reduced connections from the right SLD to the bilateral cingnlate gyrus (t =-4.173) and bilateral frontal gyrus (t =-2.965(left),-3.662(right)),from the vlPAG to the left precentral-postcentral gyrus(t =3.930),and from the vlPAG to the right frontal gyrus (t =4.141) in the iRBD.There was no statistically significant difference from the left SLD to the whole brain.Conclusion There were abnormal FCs from the SLD and vlPAG to cognitive and motor areas in RBD patients,perhaps leading to clinical RBD symptoms such as cognitive deterioration and movement disorder.

Objective To invetigate the metabolic changes in the resting brain glucose of patients with type 2 diabetes but without brain metastasis.Methods A total of 96 patients with type 2 diabetes were confirmed by 18F-FDG PET/CT examination.The whole-body 18F-FDG PET/CT images of the patients were retrospectively analyzed.Ninety-six healthy subjects were included as controls for comparison.The metabolic changes in resting brain glucose of the 96 patients with type 2 diabetes were analyzed using a statistical parametric mapping software.Data were processed with two independent sample t test of voxel to voxel in the images.Results Compared with the control group,the hypometabolic brain areas in patients with type 2 diabetes were in the bilateral middle-inferior frontal,bilateral superior-heschl gyms,bilateral superior-middle-lingual gyrus,calcarine cortex,bilateral inferior parietal gyrus,and bilateral wedge anterior lobe(t=5.51-6.42,all P＜0.001).Hypermetabolic areas were not observed in patients.Conclusions The reduced metabolic cerebral regions in the patients with type 2 diabetes involved a number of functional regions related to visual cortex and mood disorders.

Objective To explore the correlation between changes of striatal dopamine D2receptors non-displaceable binding potential (BPND) in 11C-Raclopride PET-CT and brain regional homogeneity (ReHo) derived from resting state functional MRI (fMRI) in patients with first-episode major depressive disorder (MDD) . Methods Patients with first-episode MDD and age and sex matched healthy volunteers accepted brain 11C-Raclopride PET-CT and resting state fMRI. MIAKAT based on MATLAB and Rest 1.8 were used to calculate BPNDof brain dopamine D2receptors and brain ReHo, respectively. Changes of striatal dopamine D2receptors BPNDand brain ReHo values were analyzed by paired-sample t test and two independent sample t-test, and Pearson correlation analysis was used to analyze the correlation between BPNDand ReHo. Results Twenty patients with first-episode MDD were enrolled as MDD group, and 20 healthy volunteers as the control group. The two groups were all right-handed, and there were no statistical differences for age (t =1.33,P=0.19)and gender(χ2=0.10,P=0.75). Compared with the control group, the ReHo in MDD patients increased in the bilateral striatum (caudate nucleus and putamen), bilateral medial prefrontal lobes, and right thalamic (27 to 56 voxels, P＜0.05) and decreased in the left middle frontal gyrus, the left anterior cingulate, the left hippocampal and the right amygdala (21 to 35 voxels, P＜0.05). In addition, compared with the control group, BPNDof bilateral caudate nucleus and putamen dopamine D2receptors in the MDD group were decreased (t=－4.41 to －3.13, P＜0.05). Furthermore, there was a negative correlation between D2 receptors BPNDand ReHo of bilateral caudate nucleus and putamen (r=－0.81 to－0.62, P＜0.05). And there was a negative correlation between ReHo of the bilateral medial prefrontal lobes and BPNDof the same lateral caudate nucleus and putamen D2receptors in the MDD group (r=－0.86 to－0.52, P＜0.05). Besides, ReHo of the left middle frontal gyrus, right thalamic, left anterior cingulate, left hippocampal and right amygdala had no correlation with the D2receptors BPNDof the striatum in the MDD group (－0.27 to 0.39, P＞0.05). Conclusion There were abnormal levels of dopamine neurotransmitter in the cerebral striatum regions and abnormal brain activities in the brain region associated with dopamine reward circuit in the first-episode MDD patients, and there was a correlation between the two abnormalities.

Objective To observe non-displaceable binding potential (BPND) changes of striatal dopamine D2 receptors(SDDR) in patients with first-episode major depressive disorder (MDD) using 11C-Raclopride PET/CT,and to analyze the relationship between BPND and Hamilton rating scale for depression (HAM-D).Methods From December 2014 to December 2015,patients with first-episode MDD and age/gender-matched healthy controls underwent brain MRI and 11C-Raclopride PET/CT in this prospective study.BPND of bilateral SDDR was calculated by molecular imaging and kinetic analysis toolbox (MIAKAT).BPND changes of bilateral SDDR and their relationship with HAM-D score were analyzed.Paired t test,two-sample t test and Pearson correlation analysis were used.Results A total of 20 MDD patients (8 males,12 females,average age: (32.80±9.76) years) and 20 healthy controls (9 males,11 females,average age:(29.25±6.93) years) were enrolled in this study.The 11C-Raclopride uptake in brain tissue of the MDD group and control group were mainly distributed in bilateral striatum,and very few 11C-Raclopride was distributed in bilateral cerebral cortex and cerebellum.In MDD group,the BPND level of bilateral SDDR had no statistical differences(t values: 0.69,0.35,both P>0.05),and similar results were found in the control group(t values: 0.28,0.24,both P>0.05).Compared with the control group,however,the MDD group had lower BPND level of bilateral SDDR(t values: 3.13-4.41,all P<0.05).The BPND of bilateral caudate nucleus and/or putamen D2 receptors was correlated with HAM-D total score,anxiety/somatization factor score,cognitive impairment factor score,retardation factor score and sleep disturbance factor score(r values: from-0.688 to-0.453,all P<0.05).Conclusions The binding potential of SDDR in patients with first-episode MDD is declined,and the BPND level of SDDR is correlated with symptoms of depression.The abnormality of SDDR may be an important molecular mechanism of the abnormality of midbrain-striatal dopamine reward circuits in MDD patients.

成人Still病（ adult?onset Still disease，AOSD）是一种发病机制尚未完全阐明的全身性炎性病变，目前国内外均采用排除性诊断［1］。18F?FDG PET／CT可同时提供组织结构和功能代谢信息，有望为其诊断提供帮助。笔者回顾性分析了10例在本院行18 F?FDG PET／CT显像，并最终确诊为AOSD的患者资料，现报道如下。

目的 通过对特发性快速眼球运动睡眠行为障碍(iRBD)患者认知脑区改变的探索,寻找其与帕金森病(PD)患者大脑形态改变的异同,为两者的联系提供依据.方法 对14例iRBD患者、12例PD患者及8名健康人(CON组)进行认知心理测评(复杂图形测试、临摹及回忆、符号-数字转换测试、连线测试、画钟测试、数字广度测验)及磁共振检查,采用基于体素形态学的研究技术进行分析.结果 iRBD组及PD组患者的数字符号转换测试、连线测验测试2与CON组之间的差异均有统计学意义(P<0.05),iRBD组与PD组间的差异无统计学意义(P>0.05);与CON组比较,iRBD组与PD组患者的右顶叶及左枕叶体积均缩小(P<0.05),但iRBD组与PD组间的差异无统计学意义(P>0.05);PD组右枕叶较CON组体积减小(P<0.05).结论 iRBD患者及PD患者均出现注意力及执行功能等认知能力下降,并且都出现右顶叶和枕叶萎缩,提示两者的认知损害存在相似的病理基础.

Objective To investigate the structure of corpus striatum and the integrity of white matter fiber in patients with Parkinson's disease (PD) and idiopathic rapid eye movement sleep behavior disorder (iRBD).Methods Twelve patients with iRBD,12 patients with PD and 10 healthy subjects that were well matched in gender,age and education were enrolled in this study.Head MRI examination was performed to all subjects to observe the changes of corpus striatum structure (the gray matter volume) and the integrity of white matter fiber [fractional anisotropy (FA)] by combining voxel-based morphometry (VBM) and diffusion tensor imaging (DTI).Results Compared with healhy subjects,the gray matter volume of left caudate nucleus was significantly decreased (P ＜ 0.005),and FA values of left caudate nucleus (P ＜ 0.005),right caudate nucleus (P ＜ 0.001) and right putamen (P ＜ 0.05) were all significantly reduced in iRBD patients;FA value of right putamen was significantly decreased in PD patients (P ＜ 0.05).Compared with PD patients,the gray matter volume of left caudate nucleus of iRBD patients was significantly reduced (P ＜ 0.001),FA values of left caudate nucleus (P ＜ 0.01) and right caudate nucleus (P ＜ 0.005) of iRBD patients were significantly reduced.Conclusions There is atrophy of gray matter volume and extensive white matter fiber impairment in corpus striatum of patients with iRBD,and the white matter fiber impairment was similar to PD,which provides an anatomical evidence for iRBD being presymptom of PD.

Objective To explore the relation between abnormal functional connectivity of substantia nigra and impairment of movement and cognition in patients with rapid eye movement sleep behavior disorder (RBD). Methods A total of 22 subjects, including 14 patients with RBD and 8 sex, age, education-matched healthy controls, were enrolled in this study according to international diagnostic criteria. Unified Parkinson's Disease Rating Scale Ⅲ (UPDRS Ⅲ) and Hoehn-Yahr Stage were used to evaluate motor function. Digit Ordering Test - Attention (DOT - A), Symbol Digit Modalities Test (SDMT), Stroop Color-Word Test (SCWT), Trail Making Test (TMT), Rey-Osterrieth Complex Figure Test (ROCFT), Clock Drawing Test (CDT), Boston Naming Test (BNT) and Auditory Verbal Learning Test (AVLT) were used to evaluate cognitive function. The functional connectivity from left and right substantia nigra to brain region were examined. Results There were no statistical differences of UPDRSⅢ and Hoehn?Yahr Stage between 2 groups (P > 0.05, for all). In comparison with control group, SDMT (P = 0.001), ROCFT-copy (P = 0.013) and AVLT-N2 (P = 0.032) were significantly lower, while TMT-B test was significantly higher (P =0.005) in RBD group. Compared with control group, the functional connectivity of right substantia nigra to left precentral gyrus (P < 0.005) and right angular gyrus (P < 0.005) were all decreased in RBD group. Conclusions The results suggest that cognitive impairment occurs earlier than movement disorders in RBD, and there are abnormal functional connectivity from right substantia nigra to left precentral gyrus and right angular gyrus, proving that abnormal functional connectivity is the base of behavior disorders in RBD. DOI: 10.3969/j.issn.1672-6731.2017.09.005

Objective To investigate the abnormal functional connectivity (FC) between the substantia nigra (SN) and the brain motor area in rapid eye movement sleep behavior disorder (RBD) by Unified Parkinson′s Disease Rating Scale (UPDRS), Hoehn-Yahr Scale and resting state functional magnetic resonance imaging (rfMRI).Methods A total of 34 subjects (14 with RBD (RBD group), 12 with Parkinson′s disease (PD group), and 8 age, sex-matched normal controls (control group)) recruited in the Department of Neurology, Henan Provincial People′s Hospital from 2014 to 2015 were enrolled in this study according to international diagnosis criteria.All subjects were examined by UPDRS, Hoehn-Yahr Scale and rfMRI.Results UPDRS scores and Hoehn-Yahr staging were 0.00 (0.00, 3.75) and 0.00 (0.00, 0.50) respectively in the RBD group, which were significantly different from that in the PD group (30.5 (18.75, 33.00) and 1.75 (1.50, 2.50), respectively;Z=-3.782, P<0.05 and Z=-2.963, P<0.05), whereas not significantly different from that in the control group (0.00 (0.00, 0.00),0.00 (0.00, 0.00), respectively;Z=1.16, P>0.05 and Z=1.10, P>0.05).The FC analysis showed alterations from the right SN to bilateral cerebellum respectively among the three groups (Fright cerebellum=12.975, Fleft cerebellum=6.144;P<0.05);furthermore, there were significant increases in the RBD group compared with the PD group (t=-4.602,-5.080, P<0.005).The FC analysis showed reduced correlation from the right SN to the left prefrontal cortex in the RBD and the PD groups compared with the control group (t=-4.899,-3.500, P<0.005), but there was no statistically significant difference between the RBD and the PD groups (t=2.035, P>0.05).Conclusions There was abnormal FC from the SN to motor areas in RBD patients, and partial alterations were similar as PD patients.rfMRI provided an evidence that RBD might be presymptom of PD.

Objective To explore the metabolic changes in the resting brain glucose of patients with lymphoma but without brain metastasis. Methods A total of 102 patients with histologically confirmed lymphoma without treatment underwent 18F-FDG PET/CT examination. The whole-body 18F-FDG PET/CT images of the patients were retrospectively analyzed. Fifteen patients suffered from Hodgkin′s lymphoma and 87 of them had non-Hodgkin′s lymphoma. Seventy-seven healthy subjects were included as controls for comparison. The metabolic changes in resting brain glucose of the 102 patients with lymphoma were analyzed using statistical parametric mapping software. Results Compared with the control group, hypometabolic brain areas in the patients with lymphoma were observed mainly in the bilateral superior, middle, inferior temporal gyri; bilateral superior frontal gyrus; right middle frontal gyrus; and right cerebellum. Hypermetabolic areas were not observed in our patients. Conclusions The reduced metabolic cerebral regions in the patients with lymphoma involved a number of functional regions related to mood disorder and immunity.