| 李晓东,郑晓萌,栾九松,董曦,苏剑,韩晔,李树恒.99Tcm-亚甲基二磷酸盐(MDP)xSPECT/CT定量参数评估腰椎小关节骨关节炎[J].中国医学影像技术,2026,42(6):946~950 |
| 99Tcm-亚甲基二磷酸盐(MDP)xSPECT/CT定量参数评估腰椎小关节骨关节炎 |
| 99Tcm-methylene diphosphonate (MDP) xSPECT/CT quantitative parameters for evaluating lumbar facet joint osteoarthritis |
| 投稿时间：2026-04-09 修订日期：2026-05-25 |
| DOI：10.13929/j.issn.1003-3289.2026.06.032 |
| 中文关键词: 骨关节炎 椎关节病变 单光子发射断层显像和计算机体层摄影术 |
| 英文关键词:osteoarthritis spondylarthropathies single photon emission computed tomography computed tomography |
| 基金项目:河北大学附属医院基金项目(2022QC47)。 |
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| 中文摘要: |
| 目的 观察99Tcm-亚甲基二磷酸盐(MDP)xSPECT/CT定量参数评估腰椎小关节骨关节炎(FJOA)的价值。方法 前瞻性纳入163例疑诊FJOA患者,根据视觉模拟评分(VAS)结果分为轻度(n=39)、中度(n=93)及重度疼痛组(n=31)。行99Tcm-MDP xSPECT/CT检查,以腰椎小关节局灶性放射性浓聚为显像阳性、以摄取最高处为责任关节,记录其最大标准摄取值(SUVmax)、平均标准摄取值(SUVmean)、峰值标准摄取值(SUVpeak)、病灶摄取总量(TLU)及病灶摄取总体积(TLV)。基于同机轴位CT图像以Weishaupt分级标准评估腰椎小关节退行性变程度;利用Pearson或Spearman相关系数评价xSPECT/CT定量参数与FJOA退变分级及疼痛程度的相关性。结果 xSPECT/CT于163例均检出阳性病灶(共573个)。163个责任关节中,轻度退变11个(11/163,6.75%)、中度退变66个(66/163,40.49%)、重度退变86个(86/163,52.76%);其中127个(127/163,77.91%)位于L4—5及L5—S1节段。责任关节SUVmax、SUVmean、SUVpeak、TLU及TLV均与FJOA退变分级呈弱正相关(rS=0.372~0.472,P均＜0.001),而其SUVmax、SUVmean及SUVpeak均与疼痛程度呈中度正相关(r=0.694~0.745,P均＜0.001),TLU及TLV均与疼痛程度呈弱正相关(r=0.595、0.354,P均＜0.001)。结论 99Tcm-MDP xSPECT/CT显像能准确识别FJOA责任关节,其定量参数可客观反映病变严重程度。 |
| 英文摘要: |
| Objective To observe the value of quantitative parameters of 99Tcm-methylene diphosphonate (MDP) xSPECT/CT for evaluating lumbar facet joint osteoarthritis (FJOA). Methods A total of 163 patients with suspected FJOA were prospectively enrolled and divided into mild pain (n=39), moderate pain (n=93) and severe pain (n=31) groups according to visual analogue scale (VAS) scores. 99Tcm-MDP xSPECT/CT scanning was performed. Focal radiotracer accumulation in lumbar facet joints were regarded as positive finding, and the facet joint with the maximum radiotracer uptake was taken as the symptomatic responsible joint. Quantitative parameters of the target joint were recorded, including the maximum standardized uptake value (SUVmax), the mean standardized uptake value (SUVmean), peak standardized uptake value (SUVpeak), total lesion uptake (TLU) and total lesion volume (TLV). The degree of lumbar facet joint degeneration in co-registered axial CT images was assessed using Weishaupt grading system. Pearson or Spearman correlation coefficients were adopted to analyze the correlations of xSPECT/CT quantitative parameters and degenerative grades of FJOA or pain severity. Results Positive lesions were detected in all 163 patients, with a total of 573 lesions in xSPECT/CT images. Among 163 symptomatic responsible joints, 11 exhibited mild degeneration (11/163, 6.75%), 66 exhibited moderate degeneration (66/163, 40.49%) and 86 exhibited severe degeneration (86/163, 52.76%), 127 of these joints (127/163, 77.91%) located at the L4—5 and L5—S1segments. All quantitative parameters of the symptomatic responsible joints, including SUVmax, SUVmean, SUVpeak, TLU and TLV, were weakly positively correlated with FJOA degeneration grades (rS＝0.372—0.472, all P＜0.001). SUVmax, SUVmean and SUVpeak exhibited moderate positive correlations (r＝0.694—0.745, all P＜0.001), while TLU and TLV showed weak positive correlations with pain severity (r＝0.595 and 0.354, both P＜0.001). Conclusion 99Tcm-MDP xSPECT/CT could accurately detect symptomatic responsible joints of FJOA, and its relevant quantitative parameters could objectively reflect the severity of lesion. |
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