The 2-[18F] fluoro-2-deoxy-D-glucose PET-CT manifestations of patients with anti-N-methyl-D-aspartate receptor encephalitis at different stages / 中华神经科杂志

ABSTRACT

Objective To demonstrate the manifestations on positron emission tomographycomputed tomography (PET-CT) at different stages in anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis.Methods PET-CT was performed in 10 patients with anti-NMDAR encephalitis at different clinical stages,and the images were analyzed to investigate the relation of metabolic patterns in the images with clinical presentations.Results Except for normal PET-CT images in 2 patients,images in 8 patients at early stage of the disease showed generally increased 2-[18F] fluoro-2-Deoxy-D-glucose(18F-FDG) uptake at frontal and temporal lobe,basal ganglion and cerebellum,indicating hyper-metabolism in these areas,while 2 of them also had mixture of hyper-and hypo-metabolism in parietal-occipital region.In longitudinal analysis of PET-CT images in these 8 cases,starting at basal ganglion,18 F-FDG uptake gradually decreased bilaterally,prominently at left dominant hemisphere and right cerebellum.Conclusions During the course of anti-NMDAR encephalitis,18F-FDG metabolism markedly increases at early stage and then gradually declines at late stage,at frontal,temporal,parietal and occipital lobes,basal ganglion and cerebellum,predominantly at left dominant hemisphere and right cerebellum.However,in relapsing anti-NMDAR encephalitis,18 F-FDG metabolism in brain does not show these characteristics.