Neurology:TSPO PET 有助于诊断 CNS 血管炎

2018-12-21 杨中华 脑血管病及重症文献导读

这个病例提示 TSPO PET 是有助于检测活动性 CNS 炎症,比如怀疑 CNS 血管炎的患者。

67岁,男性。

肺移植后接受免疫抑制剂他克莫司治疗,后来逐渐出现左侧痉挛性偏瘫。

MRI 显示两处弥散抑制,T2高信号伴/不伴部分强化(下图):

鉴别诊断主要包括进展性多灶性白质脑病、不典型 CNS 淋巴瘤和 CNS 血管炎。

[18F]GE-180示踪新型转位蛋白(translocator protein,TSPO)PET 显示双侧 T2高信号病灶区可见示踪剂摄取增加:



TSPO 是活化小神经胶质细胞的过度表达。

立体定向活检显示他克莫司相关 CNS 血管炎伴小胶质细胞激活。A 图,小血管壁淋巴细胞浸润(箭头,苏木精 & eosin 染色);B 图,小胶质细胞激活(CD3/43染色);C 图,星形胶质细胞活化(胶质纤维酸性蛋白染色);D 图,CD3+ T 细胞浸润。比例尺,100um:



这个病例提示 TSPO PET 是有助于检测活动性 CNS 炎症,比如怀疑 CNS 血管炎的患者。

原始出处:
Christoph Mahler, Marcus Unterrainer, Carolin Muth, et al. Imaging microglial activation in tacrolimus-associated CNS vasculitis with translocator protein PET. Neurology. Nov 2018.

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    2019-01-15 yinhl1978
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    2019-10-17 lg.zhao
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    2019-01-23 仁者大医
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