摘要
目的探讨原发性干燥综合征(pSS)患者行腮腺SPECT/CT动态显像获得的基于SUV的定量参数与唇腺病理分级的相关性。方法前瞻性纳入2022年8月至2024年3月于河北省人民医院确诊的72例pSS患者[男6例、女66例, 年龄(51.5±13.8)岁], 获取其唇腺活组织检查(简称活检)的病理分级资料, 并进行定量SPECT/CT腮腺动态显像, 通过Q-metrix软件得到基于SUV的定量参数:酸刺激前和酸刺激后SUV_(max)、SUV_(mean)、腮腺摄取体积(UVP)、腮腺摄取总量(TPU)以及酸刺激前后参数差值(Δ)。比较唇腺活检病理1~2级和3~4级患者间的各参数差异(两独立样本t检验或Mann-WhitneyU检验), 采用Spearman秩相关分析显像参数与病理分级的相关性, 利用ROC曲线(Delong检验)评估定量参数对病理1~2级与3~4级的鉴别能力。结果唇腺活检病理分级1~2级患者(n=30)较3~4级患者(n=42)的SUV_(max)高[酸刺激前:36.38(27.81, 44.17)与15.45(10.77, 24.51), Z=-5.51, P<0.001;酸刺激后:21.53(16.93, 26.21)与11.33(7.32, 15.89), Z=-5.27, P<0.001];1~2级患者酸刺激前、后SUV_(mean)、UVP、TPU以及ΔSUV_(max)、ΔSUV_(mean)、ΔTPU也较高(Z值:-4.73~-3.04, t值:6.39、4.50, 均P<0.01);上述参数与病理分级均呈负相关(rs值:-0.66~-0.36, 均P<0.05)。ΔUVP在病理分级1~2级与3~4级患者间差异无统计学意义(Z=-1.05, P=0.293), 且ΔUVP与病理分级不相关(rs=-0.13, P=0.297)。ROC曲线分析示, 酸刺激前、后SUV_(max)和酸刺激前TPU鉴别病理分级1~2级与3~4级患者的AUC(0.883、0.866和0.888)较高, Delong检验示这3个参数的AUC均高于酸刺激后SUV_(mean)、UVP和ΔUVP的AUC(均<0.800;Z值:2.09~4.65, 均P<0.05)。结论基于SUV的腮腺SPECT/CT定量参数可以反映pSS患者的腮腺损伤程度, 为pSS的功能诊断和评估提供了新的定量分析方法。
Objective:To explore the correlation between quantitative parameters based on SUV acquired by dynamic SPECT/CT imaging of parotid glands and pathological grading of labial gland in patients with primary Sj?gren syndrome(pSS).Methods:Seventy-two patients(6 males,66 females,age(51.5±13.8)years)with confirmed pSS diagnosed at Hebei General Hospital between August 2022 and March 2024 were prospectively included.The clinical data and pathological grading information from labial gland biopsies were analyzed.Dynamic SPECT/CT imaging of the parotid glands was performed,and quantitative parameters based on SUV were obtained using Q-metrix software:SUV_(max),SUV_(mean),uptake volume of parotid glands(UVP)and total parotid uptake(TPU)pre/post-acid stimulation,as well as the differences in quantitative parameters before and after acid stimulation(ΔSUV_(max),ΔSUV_(mean),ΔUVP,andΔTPU).The independent-sample t test or Mann-Whitney U test was performed to evaluate the differences in parameters between patients with pathological grade 1-2 and those with pathological grade 3-4.Spearman rank correlation was used to analyze the correlation between quantitative parameters and pathological grading.The performance of quantitative parameters in distinguishing pathological grade 1-2 from grade 3-4 was assessed using ROC curve analysis with Delong test.Results:The SUV_(max) pre/post-acid stimulation in patients with pathological grade 1-2(n=30)were higher than those in patients with grade 3-4(n=42)(36.38(27.81,44.17)vs 15.45(10.77,24.51),Z=-5.51,P<0.001(pre-acid stimulation);21.53(16.93,26.21)vs 11.33(7.32,15.89),Z=-5.27,P<0.001(post-acid stimulation)).SUV_(mean),UVP and TPU pre/post-acid stimulation in patients with pathological grade 1-2,as well asΔSUV_(max),ΔSUV_(mean) andΔTPU,were all significantly higher(Z values:from-4.73 to-3.04,t values:6.39,4.50,all P<0.01).Moreover,these parameters were negatively correlated with the pathological grading(rs values:from-0.66 to-0.36,all P<0.05).No significant difference inΔUVP was observed between patients with pathological grade 1-2 and those with grade 3-4(Z=-1.05,P=0.293),andΔUVP showed no correlation with pathological grading(rs=-0.13,P=0.297).Among all parameters,SUV_(max) pre/post-acid stimulation and TPU pre-acid stimulation exhibited better diagnostic performance in differentiating pathological grade 1-2 from grade 3-4,with AUC values of 0.883,0.866,and 0.888,respectively.Delong test showed that those 3 AUC values were all higher than AUC values of SUV_(mean),UVP post-acid stimulation andΔUVP(all AUC<0.800;Z values:2.09-4.65,all P<0.05).Conclusion:The quantitative parameters of parotid glands based on SUV acquired by dynamic SPECT/CT can reflect the damage degree of parotid glands in patients with pSS,providing novel quantitative analytical tools for the functional diagnosis and assessment of pSS.
作者
张新超
胡玉敬
田丛娜
张承铎
郑璐
底学敏
李康
刘家乐
张晶洁
边艳珠
Zhang Xinchao;Hu Yujing;Tian Congna;Zhang Chengduo;Zheng Lu;Di Xuemin;Li Kang;Liu Jiale;Zhang Jingjie;Bian Yanzhu(Department of Nuclear Medicine,Hebei General Hospital,Shijiazhuang 050051,China;Department of Nuclear Medicine,Shexian Hospital,Handan 056400,China;Department of Oncology,Hebei General Hospital,Shijiazhuang 050051,China)
出处
《中华核医学与分子影像杂志》
北大核心
2025年第9期549-554,共6页
Chinese Journal of Nuclear Medicine and Molecular Imaging
基金
河北省2024年度医学科学研究课题计划(20241560)。
