初步探讨适合心脏、心包病变的^(18)F-FDG PET/CT显像前准备方法

Searching for the reasonable patient preparation protocol for heart and pericardium lesions of patients

目的通过比较不同显像前准备方法的心肌摄取^(18)F-FDG程度,制定适合心脏、心包病变的^(18)F-FDG PET/CT显像前准备方法。方法 100例临床怀疑心脏、心包病变患者分别采用禁食(50例)和低碳水化合物高脂肪蛋白质允许饮食(50例)两种显像前准备,接着进行^(18)F-FDG PET/CT扫描。分别测量两组心肌SUVmax有无统计学差异(Mann-Whitney U Test)。结果禁食组与饮食组的患者的心肌SUVmax分别为4.6±4.0、1.9±0.9。两者之间差别有统计学意义(Z=-6.348,P=0.000),饮食组心肌SUVmax低于禁食组。结论患者行PET/CT检查前2餐采用低碳水化合物高脂肪蛋白质允许饮食,餐后3~6h内进行PET/CT扫描能够较为有效的抑制心肌摄取^(18)F-FDG,使心肌的显影程度不影响诊断,为一种较为合理的适合心脏、心包病变的^(18)F-FDG PET/CT显像前准备方法。

Objective Myocardial 18F-FDG uptake in PET scans in patients prepared by the usual fasting protocol may result in difficulties in interpretation because variable uptake may yield false-positive results regarding mediastinal abnormalities.We aimed to analyze, retrospectively, the effect of diet on myocardial FDG uptake.Methods A total of 50 patients who adhered to two meals before PET/CT scanning that were prepared using a low carbohydrate, high fat and protein-permitted diet, were compared with 50 patients who fasted for at least 12 hours prior to scanning.The differences of SUVmax of myocardium between ＂fasting＂ group and the ＂new diet＂ group were analyzed by Mann-Whitney U Test （Non-normal distribution）.Results The SUVmax of the ＂fasting＂ group was 4.6±4.0, and the SUVmax of the ＂new diet＂ group was 1.9±0.9.This showed significant difference by Mann-Whitney U Test （Z =-6.348, P=0.000）.Conclusion A very high-fat, low-carbohydrate, protein-permitted diet before FDG injection suppresses myocardial FDG uptake.This should facilitate definition of mediastinal abnormalities on FDG PET.It is a more reasonable patient preparation protocol for the patients with heart and pericardium lesions.