100名健康者肾上腺^18F-FDG PET／CT显像分析

^18F-FDG PET/CT imaging of 100 normal adrenal gland cases

目的探讨正常肾上腺^18F-脱氧葡萄糖（FDG）PET显像特征，为在^18F-FDG PET或PET／CT显像中判断肾上腺是否有高代谢灶提供依据。方法选择行PET／CT体格检查的健康者100名。图像分析采用目测计分和测定标准摄取值（SUV）2种方法。目测计分法以肝为对照，肾上腺未显影为0分，放射性摄取低于肝放射性为1分，等于肝放射性为2分，高于肝放射性为3分；SUV由图像横断面测量，依据CT所显示的肾上腺和肝，手动勾画感兴趣区（ROI），获得左右两侧肾上腺、肝的SUV平均值（SUVavg）、SUV最大值（SUVmax），再计算肾上腺与肝SUV的比值。结果（1）目测分析：左、右侧正常肾上腺放射性摄取分别有94％和91％等于或低于肝。（2）左、右侧正常肾上腺95％可信区间（CI）上限，SUVavg分别为1．39和1．65，SUVmax分别为1．98和2．19。（3）左、右侧正常肾上腺／肝比值的95％CI上限，SUVavg分别为0．65和0．75，SUVmax分别为0．76和0．83。（4）左、右侧肾上腺对^18F-FDG摄取有一定差异，右侧肾上腺SUVavg和SUVmax均高于左侧。（5）除右侧SUVmax男性高于女性外，余各组性别差异无统计学意义。（6）正常肾上腺对^18F-FDG摄取在〈60岁组和≥60岁组的差异无统计学意义。结论正常肾上腺^18F-FDG生理性摄取程度的主要表现为低于肝。

Objective The purpose of this study was to obtain the ,^18F-fluorodeoxyglucose （FDG） uptake characteristics in normal adrenal gland as the criteria to diagnose abnormal glucose metabolism in adrenal gland by ^18F-FDG PET or PET/CT imaging. Methods One hundred healthy persons underwent ^18F- FDG PET/CT imaging in this study. The images were reviewed by visual judgement and measured by standardized uptake value （SUV）. With reference to normal liver, the uptake of adrenal gland was scored from 0 to 3, namely, 0 = no uptake, 1 = less than the uptake of normal liver, 2 = equal to the uptake of normal liver, 3 = more than the uptake of normal liver. SUV was measured on the trans-axial images. The regions of interest （ROIs） of adrenal glands and livers were manually drawn based on the CT images. Both average SUV（SUVavg）and maximum SUV（SUVmax）were calculated. Results （1）By visual judgment, 94% and 91% of left and right normal adrenal glands had uptake intensity less than that of livers. （2） The SUV,vs of left and right adrenal glands were 1.39 and 1.65, and the SUVmax 1.98 and 2.19, respectively with the upper limit of 95% confidence interval （CI）. （3）The ratios of left and right adrenal glands SUVavg to livers SUVavg were 0.65 and 0.75 and left and right adrenal glands SUVmax to livers SUVmax were 0.76 and 0.83 respectively with the upper limit of 95% CI. （4）The uptake of right adrenal gland was higher than that of the left. （5） There was no significant difference of the SUVs between men and women, except that right adrenal gland SUVmax of men was higher than that of women. （ 6 ） There was no significant difference in ^18F- FDG uptake between persons younger and elder than 60 years old. Conclusion The physiological FDG up- take of the adrenal gland in normal healthy individuals is generally lower than that of liver.