抗LGI1抗体自身免疫性脑炎18F-FDG PET/CT影像学特征

doi:10. 3969/ j. issn. 1006-7795. 2024. 01. 002

首都医科大学学报

• 核医学与分子影像辅助临床诊疗 • 上一篇下一篇

抗LGI1抗体自身免疫性脑炎18F-FDG PET/CT影像学特征

李晓桐¹，赵晓斌¹，吕瑞娟²，袁磊磊¹，陈谦¹，王群²，艾林^1*

1.首都医科大学附属北京天坛医院核医学科，北京 100070；2.首都医科大学附属北京天坛医院神经内科，北京 100070

收稿日期:2023-10-18 出版日期:2024-03-21 发布日期:2024-03-21
通讯作者: 艾林 E-mail:E-mail：ailin@bjtth.org
基金资助:
国家自然科学基金项目（82371449，81771143），北京市自然科学基金项目（7192054）。

18F-FDG PET/CT imaging features of autoimmune encephalitis with anti-LGI1 antibody

Li Xiaotong¹, Zhao Xiaobin¹, Lyu Ruijuan², Yuan Leilei¹, Chen Qian¹, Wang Qun², Ai Lin^1*

1.Department of Nuclear Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070，China; 2. Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070，China

Received:2023-10-18 Online:2024-03-21 Published:2024-03-21
Supported by:
This study was supported by National Natural Science Foundation of China （82371449， 81771143), Natural Science Foundation of Beijing（7192054）.

摘要/Abstract

摘要： 目的研究抗富亮氨酸胶质瘤失活1蛋白（leucine-rich glioma-inactivated 1，LGI1）抗体自身免疫性脑炎（autoimmune encephalitis，AE）患者头部¹⁸F-脱氧葡萄糖（¹⁸F-deoxyglucose，FDG）正电子发射计算机断层显像（positron emission tomography，PET）/电子计算机断层显像（computed tomography，CT）影像学特点，探讨PET/CT在抗LGI1-AE早期诊断中的应用价值。方法回顾性分析2014年10月至2020年11月在首都医科大学附属北京天坛医院神经内科诊断为LGI1-AE的43例患者［其中急性期24例（56%），慢性期19例（44%）］的资料，分析患者¹⁸F-FDG PET/CT的影像及临床特征。结果 ¹⁸F-FDG PET显像结果显示，40例（93%）LGI1-AE患者出现明显的代谢异常，而只有26例（60%）患者出现异常磁共振（magnetic resonance imaging，MRI）信号（P<0.05）。18F-FDG PET代谢异常在治疗后是可逆的，大多数患者出院后¹⁸F-FDG PET的代谢几乎均正常。LGI1-AE患者的高代谢区位于基底节区（basal ganglia，BG）和内侧颞叶（medial temporal lobe，MTL）。在33例（77%）患者中观察到BG区高代谢，72%的患者表现出MTL高代谢。共有22例患者（51%）表现出面臂肌张力障碍性癫痫发作（faciobrachial dystonic seizures，FBDS），其余患者表现出非FBDS症状（49%）。FBDS患者中有7例（7/21）检测到仅BG区高代谢，而非FBDS患者中只有2例患者（2/19）检测到BG区高代谢（33% vs 10%，P<0.05）。结论 ¹⁸F-FDG PET/CT对抗LGI1-AE患者的早期诊断阳性率高。FBDS患者多表现为仅BG区高代谢，这表明BG区可能参与FBDS发作。

关键词: 抗LGI1抗体, 脑炎, 自身免疫性疾病, 脱氧葡萄糖, 正电子发射断层显像术

Abstract: Objective To study the imaging features of ¹⁸F-deoxyglucose (FDG) positron emission tomography（PET）/computed tomography（CT） in the head of patients with anti-leucine-rich glioma-inactivated 1 （LGI1） antibody autoimmune encephalitis (AE), and to evaluate the value of PET/CT in the early diagnosis of anti-LGI1 antibody AE. Methods The data of 43 patients with LGI1-AE diagnosed in the Department of Neurology, Beijing Tiantan Hospital, Capital Medical University from October 2014 to November 2020 were retrospectively analyzed, including 24 patients in acute phase (56%), 19 patients in chronic phase (44%), and AE patients whose anti-LGI1 autoimmune antibodies were positive in cerebrospinal fluid or/and serum. The imaging and clinical features of ¹⁸F-FDG PET/CT were analyzed. Results ¹⁸F-FDG PET imaging showed that 40 LGI1-AE patients (93%) had obvious metabolic abnormalities, while only 26 patients (60%) had abnormal magnetic resonance imaging (MRI) signals (P < 0.05). The abnormal metabolism of ¹⁸F-FDG PET is reversible after treatment, and the metabolism of 18F-FDG PET in most patients is almost normal after discharge. The hypermetabolic regions of patients with LGI1-AE are located in the basal ganglia (BG) and medial temporal lobe (MTL). Hypermetabolism in the BG was observed in 33 patients (77%), and hypermetabolism in the MTL was observed in 72% of the patients. A total of 22 patients (51%) showed facial arm dystonia seizures (FBDS), whereas rest showed non-FBDS symptoms (49%). Hypermetabolism in the BG was detected only in 7 patients with FBDS (7/21), while that detected in only 2 patients without FBDS (2/19) (33% vs 10%). Conclusion ¹⁸F-FDG PET imaging was more sensitive in the early diagnosis of LGI1-AE. Most of the patients with FBDS showed hypermetabolism isolated in the BG, suggesting the potential involvement of the BG.

Key words: anti-leucine-rich glioma-inactivated 1（ LGI1）antibody, , encephalitis, autoimmune disease, 18F-deoxyglucose（18F-FDG）, positron emission tomography（PET）

中图分类号:

R730.44

李晓桐, 赵晓斌, 吕瑞娟, 袁磊磊, 陈谦, 王群, 艾林. 抗LGI1抗体自身免疫性脑炎18F-FDG PET/CT影像学特征[J]. 首都医科大学学报, doi: 10. 3969/ j. issn. 1006-7795. 2024. 01. 002.

Li Xiaotong, Zhao Xiaobin, Lyu Ruijuan, Yuan Leilei, Chen Qian, Wang Qun, Ai Lin. 18F-FDG PET/CT imaging features of autoimmune encephalitis with anti-LGI1 antibody[J]. Journal of Capital Medical University, doi: 10. 3969/ j. issn. 1006-7795. 2024. 01. 002.

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抗LGI1抗体自身免疫性脑炎18F-FDG PET/CT影像学特征

18F-FDG PET/CT imaging features of autoimmune encephalitis with anti-LGI1 antibody

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