健康成年人腰椎椎体骨髓18F-FDG生理性摄取规律的观察性研究

Observational study of the physiological uptake of 18F-FDG in lumbar vertebral bone marrow in healthy adults

    摘要
  • 摘要:
    目的  分析健康成年人腰椎椎体骨髓18F-氟脱氧葡萄糖（FDG）生理性摄取的规律。
    方法  回顾性分析2010年6月至2018年6月在山西医科大学第一医院行18F-FDG PET/CT检查的受检者中的323名健康成年人的临床资料，其中男性161名、女性162名，年龄（54.8±13.9）岁，范围30~78岁。将受检者按照年龄段分为30~39岁组、40~49岁组、50~59岁组、60~69岁组和70~79岁组，各组男性和女性人数分别为30和30名、36和40名、31和30名、 32和30名、 32和32名。分别在腰2、腰3、腰4椎体上勾画感兴趣区，测量其平均标准化摄取值（SUVmean）。腰椎椎体骨髓 SUVmean定义为这3个椎体SUVmean的均值，并用来表示腰椎椎体骨髓18F-FDG摄取程度。采用Pearson或Spearman秩相关分析分析受检者年龄与SUVmean的相关性；比较不同年龄组及性别的受检者间SUVmean的差异，组内比较采用独立样本t检验或Mann-Whitney U检验，组间比较采用 Kruskal-Wallis H检验和Bonferroni法。
    结果  所有受检者、男性受检者和女性受检者腰椎椎体骨髓SUVmean均与年龄呈负相关（r=−0.520，−0.451、−0.579，均P<0.001），但SUVmean并不随年龄增长呈均匀线性下降。在女性受检者中，各年龄组间腰椎椎体骨髓SUVmean的比较结果显示，50~59岁组低于40~49岁组（1.45±0.32）对（1.75±0.44）、70~79岁组低于60~69岁组（1.18±0.17）对（1.45±0.31），且差异均有统计学意义（H=2.848、3.114，均P<0.05），而在30~39岁组与40~49岁组间、50~59岁组与60~69岁组间腰椎椎体骨髓SUVmean的差异均无统计学意义（H=0.371、0.220，均P>0.05），提示女性腰椎椎体骨髓SUVmean在随年龄增长下降的过程中出现两个平台期，平台期内腰椎椎体骨髓SUVmean未随年龄增长而降低。在男性受检者中，70~79岁组腰椎椎体骨髓SUVmean低于60~69岁组（1.14±0.22）对（1.42±0.34），且差异有统计学意义（H=3.210，P<0.05），其余各相邻年龄组间的差异均无统计学意义（H=1.631、0.724、0.585，均P>0.05）。在50岁以下的各年龄组（30~39岁组、40~49岁组）中，男性和女性的腰椎椎体骨髓SUVmean的差异均有统计学意义（Z=−2.204、t=−2.918，均P<0.05）；在50岁及以上的各年龄组（50~59岁组、60~69岁组和70~79岁组）中，男性和女性腰椎椎体骨髓SUVmean的差异均无统计学意义（t=−0.483、−0.592、−0.847，均P>0.05）。
    结论 健康成年人腰椎椎体骨髓18F-FDG生理性摄取随着年龄增长而降低，但并非呈均匀线性下降，且男性与女性略有不同。

     

    Abstract:
    Objective  To analyze the patterns of physiological uptake of 18F-fluorodeoxyglucose (FDG) in lumbar vertebral bone marrow in healthy adults.
    Methods  A retrospective analysis was performed on 323 healthy adults who underwent 18F-FDG PET/CT examination at the First Hospital of Shanxi Medical University from June 2010 to June 2018. Among the participants, 161 were males and 162 were females, respectively, aged (54.8±13.9) years, ranging from 30 to 78 years. The subjects were divided into 30–39-year-old group, 40–49-year-old group, 50–59-year-old group, 60–69-year-old group, and 70–79-year-old group; the numbers of males and females in each group were 30 and 30, 36 and 40, 31 and 30, 32 and 30, and 32 and 32, respectively. The regions of interest were delineated on lumbar 2–4 vertebrae, and their mean standardized uptake value (SUVmean) were measured. Lumbar vertebral bone marrow SUVmean, defined as the average of these three vertebral bodies, was used to indicate the degree of 18F-FDG uptake of the lumbar vertebral bone marrow. Pearson's or Spearman's rank correlation analysis was employed to assess the correlation between participants' age and SUVmean. Differences in SUVmean among various age and gender groups were compared, with within-group comparisons conducted using independent sample t-test or the Mann-Whitney U test and between-group comparisons performed using the Kruskal-Wallis H test and the Bonferroni method.
    Results  The lumbar vertebral bone marrow SUVmean were negatively correlated with age in all participants, males, and females, respectively (r=−0.520, −0.451, −0.579; all P<0.001). However, the SUVmean did not decrease uniformly and linearly with age. Among female participants, the lumbar vertebral bone marrow SUVmean of the 50–59-year-old group (1.45±0.32) was lower than that of the 40–49-year-old group (1.75±0.44), and the lumbar vertebral bone marrow SUVmean of the 70–79 year-old group (1.18±0.17) was lower than that of the 60–69-year-old group (1.45±0.31), with both differences being statistically significant (H=2.848, 3.114; both P<0.05). By contrast, differences in the lumbar vertebral bone marrow SUVmax between the 30−39-year-old group and 40−49-year-old group and between the 50−59-year-old group and 60−69-year-old group were not statistically significant (H=0.371, 0.220; both P>0.05), indicating that there were two plateau periods in the decline of female lumber vertebral bone marrow SUVmax with age, where the lumbar vertebral bone marrow SUVmean did not decrease with age. Among male participants, the lumbar vertebral bone marrow SUVmean of the 70–79-year-old group (1.14±0.22) was lower than that of the 60–69-year-old group (1.42±0.34), and the difference was statistically significant (H=3.210, P<0.05). No significant difference was found among the other adjacent age groups (H=1.631, 0.724, 0.585; all P>0.05). The differences in the lumbar vertebral bone marrow SUVmean between males and females under 50 years old (30–39- and 40–49-year-old groups) were statistically significant (Z=−2.204, t=−2.918; both P<0.05). However, in the age groups of 50 years and above (50–59-, 60–69-, and 70–79-year-old groups), the differences in the lumbar vertebral bone marrow SUVmean between males and females were not statistically significant (t=−0.483, −0.592, −0.847; all P>0.05).
    Conclusion  Physiological uptake of 18F-FDG in healthy adult lumbar vertebral bone marrow decreases with age, but it does not decrease uniformly and linearly, and it is slightly different in males and females.

     

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