非霍奇金淋巴瘤患者脑葡萄糖代谢改变的统计参数图分析

Statistical parametric mapping for cerebral glucose metabolism in non-Hodgkin's lymphoma patients

目的探讨非霍奇金淋巴瘤(NHL)患者脑葡糖糖代谢改变的特点。方法回顾性分析解放军总医院2015年1月至2016年5月95例未经治疗的体部NHL患者和60例健康体检者脑部^(18)氟-脱氧葡萄糖(^(18)F-FDG)正电子发射计算机断层显像(PET/CT)图像,通过统计参数图(SPM)软件在一定显著性水平(P<0.001)和体素阈值(K=125体素)下分析NHL患者与60例健康体检者、以及14例>60岁和81例≤60岁NHL患者脑部葡萄糖代谢改变的特征和脑区分布。结果与对照组相比,NHL患者未发现代谢增高的脑区,但存在多个脑区的葡萄糖代谢减低,减低区主要位于部分双侧枕叶、左侧额下回、双侧中央前回,且左侧葡萄糖代谢减低区域的范围较右侧更广泛。>60岁NHL组和≤60岁NHL组相比,>60岁NHL患者脑部葡萄糖代谢出现减低区和增高区,减低区主要存在于双侧额叶,增高区主要存在于双侧小脑。结论 NHL患者脑葡糖糖代谢减低并非全脑性分布,而是以区域性葡萄糖代谢减低为特征,涉及脑区可能与患者的精神情感功能及免疫改变有关。>60岁NHL患者葡萄糖代谢减低区域更广泛,可能与脑老化改变相关。

Objective To investigate the characteristics of cerebral glucose metabolism in the patients with non-Hodgkin＇s lymphoma （NHL）.Methods A retrospective analysis was carried out in 95 patients with freshly diagnosed and untreated NHL and 60 healthy volunteers in our hospital from January 2015 to May 2016.The results of cerebral 18F-fluorodeoxyglucose positron emission computerized tomography and computer tomography （18F-FDG PET/CT scanning） were collected.Statistical parametric mapping （SPM） was performed under a certain significance level （P〈0.001） and voxel threshold （K=125 voxel） for the changes of cerebral glucose metabolism and distribution in the healthy volunteers, and the NHL patients （14 patients over 60 years old, and 81 younger than 60 years）.Results Compared with control group, increased glucose metabolism was not found in NHL patients.NHL patients showed the decreased glucose metabolism in the bilateral occipital lobes, left inferior frontal gyri, and bilateral precentral gyri.The area with decreased glucose metabolism was more extensive in the left brain than in the right brain.Compared with NHL patients aged ≤ 60 years, patients aged 〉 60 years had both increased and decreased glucose metabolism in the brain, with decreased glucose metabolism mainly in bilateral frontal lobe and increased glucose metabolism mainly in the bilateral cerebellum.Conclusion Patients with NHL could exhibit decreased glucose metabolism, which is not distributed in the whole brain, but regionally.The involved brain regions may be related to the mental and affective functions and changes of immune function.The decreased glucose metabolism is distributed more extensively in the NHL patients over 60 years, which might be associated with the aging changes in the brain.