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腰椎间盘突出症患者受累下肢骨骼肌代谢与功能的18-FDGPETCT研究
Study of lower extremity muscles metabolism and function in lumbar disc herniation patients by 18F-fluorodeoxyglucose PET/CT imaging

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DOI:
作者:
沈海敏 刘奕 何薇 张旻佳 蔡晓唏
SHENG Haimin, LIU Yi, HE Wei, ZHANG Minjia, CAI Xi
作者单位:
华东医院骨科
Department of Orthopaedic Surgery, Huadong Hospital Afflicated to Fudan University
关键词:
腰椎间盘突出症；下肢；肌肉；18F-FDG；PET/CT
Lumbar disc herniation; Low extremity; Muscle; 18-FDG; PET/CT
摘要:
目的 通过18F-FDG PET/CT分析比对腰椎间盘突出患者下肢骨骼肌组织葡萄糖代谢改变情况。方法 对22例单侧单节段腰椎间盘突出症患者的双侧小腿肌肉进行18F-FDG PET/CT检测，分别测定双下肢小腿前后肌群SUVmax，并进行分析比对。结果 腰椎间盘突出患侧小腿受累肌群SUVmax（0.05±0.03和0.06±0.03）均较健侧（0.29±0.13和0.23±0.18）降低，且存在显著性（P<0.01）。患侧受累肌群和健侧SUVmax差值与Oswestry功能障碍指数呈现显著正相关性（R2=0.974, P<0.01）；与JOA评分显著负相关（R2=-0.779, P<0.01）。6例手术治疗术后6月患侧受累肌群SUVmax均较术前显著增加（P<0.01）。结论 腰椎间盘突出症患者腰骶神经慢性卡压可致下肢受累骨骼肌葡萄糖代谢改变。该变化可通过18F-FDG PET/CT测定评估。18F-FDG PET/CT可作为腰椎间盘突出症患者下肢肌肉功能改变评估方法之一。
Objective To compare and analyse the glucose metabolism of lower extremity musles in lumbar disc herniation(LDH) patients by 18F-fluorodeoxyglucose PET/CT imaging. Methods Twenty-two cases of single-level unilateral lumbar disc herniation patients were enrolled in this study. Their low extremities SUVmax were detected by 18F-FDG PET/CT, and the results were analysed and compared. Results The involved muscles SUVmax were significantly lower than contralateral muscles(0.05±0.03 and 0.06±0.03, P<0.01), the defferences between ipsilateral and contralateral SUVmax were significantly positively correlated with Oswestry score(R2=0.974, P<0.01), and significantly negatively correlated with JOA score. Six cases were underwent surgery. The 6 months postoperative involved muscles SUVmaxs were significantly higher than preoperative（P<0.01). Results The chronic compression of lumbosacral nerve in LDH patients could induce to involved low extremity muscles changes of glucose metabolism. These changes could be detected by 18-FDG PET/CT. 18F-FDG PET/CT would be one of methods to evaluate low extremity muscle function in LDH patients.

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