| 张凌,谢晟,乔树宾,耿庆海,田月琴.肥厚型心肌病患者18F-FDG PET心肌代谢显像与心脏MRI[J].中国医学影像技术,2019,35(3):347~351 |
| 肥厚型心肌病患者18F-FDG PET心肌代谢显像与心脏MRI |
| 18F-FDG PET glucose metabolism imaging and MRI in patients with hypertrophic cardiomyopathy |
| 投稿时间：2018-08-23 修订日期：2018-12-28 |
| DOI：10.13929/j.1003-3289.201808152 |
| 中文关键词: 心肌病,肥厚性 正电子发射断层显像术 氟脱氧葡萄糖F18 磁共振成像 |
| 英文关键词:cardiomyopathy,hypertrophic positron emission tomography fludeoxyglucose F 18 magnetic resonance imaging |
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| 中文摘要: |
| 目的 评价肥厚型心肌病（HCM）患者空腹及糖负荷状态下18F-FDG PET心肌葡萄糖代谢的变化。方法 对36例HCM患者行心脏MRI（CMRI）和空腹+糖负荷状态18F-FDG PET显像，对心肌代谢显像图像进行半定量评分。根据CMRI结果将患者分为延迟强化组（n=24）及无延迟强化组（n=12），比较2组心肌代谢评分的差异。结果 空腹状态下延迟强化组左心室心肌代谢总评分较无延迟强化组明显减低；糖负荷状态下，2组代谢总评分差异无统计学意义。11例42个心肌节段在空腹状态下放射性摄取正常或增高，而糖负荷状态下放射性摄取稀疏或缺损，与其他25例比较，其室间隔厚度、左心室后壁厚度明显增加，延迟强化心肌节段数增多，左心室射血分数明显减低，差异均有统计学意义（P均<0.05）。结论 HCM患者空腹与糖负荷状态下18F-FDG PET心肌葡萄糖代谢显像表现出不均一性，结合CMRI，有望作为HCM患者危险度分层的指标。 |
| 英文摘要: |
| Objective To assess the changes of glucose metabolism in hypertrophic cardiomyopathy (HCM) patients with 18F-FDG PET in fasting and glucose-loading states. Methods Totally 36 patients with HCM underwent cardiac MRI (CMRI) and twice 18F-FDG PET, once in fasting state and once during glucose load state. Semiquantified assessment of metabolism score to PET images was analyzed. According to the delay enhancement (DE) on CMRI, HCM patients were divided into DE-positive group (n=24) and DE-negative group (n=12). Then the difference of semiquantified scores was compared. Results In fasting state, patients in DE-positive group had lower summed metabolism scores than those in DE-negative group (23.73±7.02 vs 36.24±14.18, P=0.015), while there was no significant difference in glucose-loading state (6.25±10.63 vs 4.38±7.41, P=0.099). Totally 11 patients had 42 myocardial segments which were normal or with improved uptake in fasting state, but defected or sparse during glucose load state. Compared with other 25 patients, these 11 patients had greater left ventricular wall thickness and greater left ventricular posterior wall thickness, more segments with DE and lower left ventricular ejection fraction (all P<0.05). Conclusion 18F-FDG PET myocardial glucose metabolism imaging in HCM patients in fasting state and during glucose load state shows obvious heterogeneity. Combined with CMRI, it may be used as an indicator of risk stratification in patients with HCM. |
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