葡萄糖/胰岛素负荷后正常及冬眠心肌^(18)F-氟脱氧葡萄糖摄取状态研究  

Study on the uptake status of ^(18)F-FDG in normal and hibernating myocardium after glucose/insulin load

作　　者：郭佳 张国旭 王治国 刘凤敏 吴锐先 GUO Jia;ZHANG Guo-xu;WANG Zhi-guo;LIU Feng-min;WU Rui-xian(Department of Nuclear Medicine,General Hospital of Northem Theater Command,Shenyang 110016,China)

机构地区：[1]北部战区总医院核医学科,辽宁沈阳110016

出　　处：《临床军医杂志》2018年第11期1273-1275,共3页Clinical Journal of Medical Officers

基　　金：辽宁省自然科学基金(2012225019)

摘　　要：目的探讨正常与冬眠心肌在口服葡萄糖和静脉内胰岛素负荷后对^(18)F-氟脱氧葡萄糖(^(18)F-FDG)的摄取状态。方法选取自2011年6月至2016年9月在北部战区总医院同时行静息及运动负荷心肌灌注单光子发射计算机断层扫描(SPECT)及^(18)F-FDG心肌正电子发射计算机断层扫描(PET)显像的102例患者为研究对象。其中,糖尿病患者62例(糖尿病组),非糖尿病患者40例(非糖尿病组);另外,根据心肌血流灌注固定缺损区域的不同程度,分为^(18)F-FDG摄取患者67例(A组),无^(18)F-FDG摄取患者35例(B组)。比较糖尿病组与非糖尿病组、A组与B组患者的^(18)F-FDG摄取状态。结果 A组中血流灌注正常的心肌节段显示,^(18)F-FDG摄取缺失或减少者40例(59.7%),B组^(18)F-FDG摄取缺失或减少者9例(25.7%),两组间比较,差异有统计学意义(P<0.05)。糖尿病组血流灌注正常的心肌节段显示,^(18)F-FDG摄取缺失或减少者40例(64.5%),非糖尿病组^(18)F-FDG缺失或减少者9例(22.5%),两组间比较,差异有统计学意义(P<0.05)。结论葡萄糖/胰岛素负荷方式及患者本底血糖水平对判断冬眠心肌存在一定影响,故在解释PET图像时应考虑患者本身血糖水平的影响,防止假性结果的出现;^(18)F-FDG PET心肌代谢显像时,葡萄糖/胰岛素负荷方案的选择有待进一步完善。Objective To investigate the uptake of ^18F-FDG in normal and hibernating myocardium after oral glucose and intravenous insulin loading. Methods A retrospective study was performed on 102 cases of patients who were performed resting and stress myocardial perfusion single photon emission computed tomography（SPECT）and ^18F-FDG myocardial positron emission tomography（PET）imaging from June 2011 to September 2016.In all cases,there were 62 diabetes patients（diabetic group）and 40 non-diabetes patients（non-diabetic group）;67 patients with different degrees of ^18F-FDG uptake in the myocardial perfusion defect area（Group A）,and 35 patients without ^18F-FDG uptake in the myocardial perfusion defect area（Group B）.The uptake status of ^18F-FDG was compared between diabetic group and non-diabetic group,Group A and Group B.Results Normal myocardial segment of blood perfusion in Group A showed deficiency or reduce of ^18F-FDG uptake in 40 cases（59.7%）,and deficiency or reduce of ^18F-FDG uptake in Group B in 9 cases（25.7%）.The difference between the two groups was statistically significant（ P 〈0.05）.Normal myocardial segment of blood perfusion in the diabetic group showed deficiency or reduce of ^18F-FDG in 40 cases（64.5%）,and deficiency or reduce of ^18F-FDG in 9 cases（22.5%）in non-diabetic group,and the difference was statistically significant（ P 〈0.05）.Conclusion The glucose/insulin loading method and the patients′ background blood glucose level have a certain influence on the judgment of hibernating myocardium.Therefore,in the interpretation of PET images,the influence of the patients′ own blood glucose level should be taken into account to prevent the appearance of false results.In the ^18F-FDG PET myocardial metabolism imaging,the choice of glucose/insulin loading scheme needs to be further improved.

关 键 词：^18F-氟脱氧葡萄糖 冬眠心肌 正电子发射计算机断层扫描 单光子发射计算机断层扫描 葡萄糖/胰岛素负荷 

分 类 号：R817[医药卫生—影像医学与核医学]