实用肝脏病杂志 ›› 2019, Vol. 22 ›› Issue (2): 256-259.doi: 10.3969/j.issn.1672-5069.2019.02.026

• 肝癌 • 上一篇    下一篇

血糖水平对原发性肝癌患者18F-FDG摄取和PET/CT检查图像质量的影响研究*

李克田,沈明格,王凤荣,胡春荣,曹玉杰,芦鹏   

  1. 154002 黑龙江省佳木斯市 佳木斯大学附属第一医院核医学科(李克田,王凤荣);
    急诊科(沈明格,曹玉杰);
    医务科(胡春荣,芦鹏)
  • 收稿日期:2018-06-20 出版日期:2019-03-10 发布日期:2019-03-19
  • 通讯作者: 胡春荣, E-mail:liketian123@sina.com
  • 作者简介:李克田,男,55岁,副主任医师,科主任。E-mail:xkoihj@163.com
  • 基金资助:
    *黑龙江省教育厅基础研究计划项目(编号:2016-KYYWF-0601)

Impact of blood glucose levels on imaging quality of PET/CT examination in patients with primary liver cancer

Li Ketian, Shen Mingge, Wang Fengrong, Hu Chunrong, Cao Yujie, Lu Peng   

  1. Department of Nuclear Medicine,First Affiliated Hospital, Jiamusi University,Jiamusi 154002,Heilongjiang Province,China
  • Received:2018-06-20 Online:2019-03-10 Published:2019-03-19

摘要: 目的 探讨原发性肝癌(PLC)患者血糖水平对肝脏氟脱氧葡萄糖F1818F-FDG)摄取的影响。方法 2015年1月~2018年1月我院行正电子发射断层显像/电子计算机断层扫描(PET/CT)检查的PLC患者187例,其中空腹血糖水平正常者71例,高血糖者116例。在PET/CT检查后,测量肝右叶平均标准化摄取值(SUVmean)。比较两组肝图像质量和18F-FDG摄取结果,采用相关分析和偏相关分析计算连续性变量与肝脏SUVmean间的相关系数和偏相关系数,再行多元逐步线性回归分析影响肝脏SUVmean的影响因素。结果 血糖正常患者肝图像质量为0级者5例(7.0%),1级者14例(19.7%),显著低于血糖升高患者的20例(17.2%)和31例(26.7%),肝图像质量为2级者21例(29.5%),为3级者31例(43.8%),显著高于血糖升高患者的30例(25.8%)和35例(30.3%,P<0.05);高血糖组患者肝脏18F-FDG摄取为(5.1±1.4),显著高于血糖水平正常组患者【(3.9±1.3),P<0.05】;血糖、年龄、FT3和基础代谢率(BMR)与SUVmean间的相关和偏相关系数均存在统计学意义(P<0.05),多元回归分析显示,血糖、年龄和血清甲状腺素(FT3)是影响肝脏SUVmean变化的独立因素。结论 血糖水平可影响PLC患者肝脏18F-FDG摄取和PET/CT检查图像质量,而年龄和血清FT3也是影响肝脏SUVmean变化的独立因素。临床在行18F-FDG PET/CT检查前,应积极调控血糖水平至合理范围,并在判读PET/CT检查图像时,考虑到这些因素的影响。

关键词: 原发性肝癌, 正电子发射断层显像/电子计算机断层扫描, 氟脱氧葡萄糖F18摄取, 血糖, 影响因素

Abstract: Objective To explore the impact of blood glucose levels on imaging quality of positron emission tomography/computed tomography (PET/CT) examination in patients with primary liver cancer (PLC). Methods 187 patients with PLC were recruited in this study between January 2015 and January 2018,and 71 had normal blood glucose and 116 were hyperglycemic. All patients received PET/CT examination. SUVmean was measured in the right lobe of the liver. The liver image quality and fluorodeoxyglucose F1818F-FDG) uptake were compared between the two groups,and the correlation of each variable to liver SUVmean was analyzed. Results The grade 0,1,2 and 3 of liver image quality by PET/CT scan in patients with normal blood glucose levels 7.0%,19.7%,29.5% and 43.8%,significantly superior to 17.2%,26.7%,25.8% and 30.3% in patients with elevated blood glucose levels (P<0.05);the 18F-FDG uptake in patients with hyperglycemia was significantly higher than in patients with normal blood glucose [(5.1±1.4) vs.(3.9±1.3),P<0.05];Correlation and partial correlation coefficients between blood glucose,age,free thyroxine 3(FT3) and liver BMR,and SUVmean were statistically significant(P<0.05) and further multivariate stepwise linear regression analysis showed that blood glucose,age and FT3 were the independent factors affecting liver SUVmean. Conclusion s Blood glucose levels and liver glucose metabolism might affect liver 18F-FDG uptake and the image quality of PET/CT scan in patientswith PLC,and the patients’ age and serum FT3 are independent factors affecting liver SUVmean. Clinicians should actively regulate the blood glucose levels to a reasonable range before PET/CT examination.

Key words: Hepatoma, Positron emission tomography/computed tomography, Fluorodeoxyglucose F18, Blood glucose, Affecting factors