淋巴瘤患者化疗相关性脂肪肝组织FDG代谢变化的初步探讨

莫奕文; 李沅桦; 李璐; 龙文; 张旭; 雷丹; 樊卫

doi:10.19732/j.cnki.2096-6210.2019.02.003

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淋巴瘤患者化疗相关性脂肪肝组织FDG代谢变化的初步探讨

论著 | 更新时间：2025-12-15

- 淋巴瘤患者化疗相关性脂肪肝组织FDG代谢变化的初步探讨
- Changes in metabolic distribution of FDG in chemotherapy-associated hepatic steatosis tissues in lymphoma patients
- 肿瘤影像学 2019年28卷第2期页码：78-83
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- DOI：10.19732/j.cnki.2096-6210.2019.02.003
  中图分类号：
- 网络出版：2019-05-24，
  
  纸质出版：2019-05-24
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莫奕文,李沅桦,李璐,等. 淋巴瘤患者化疗相关性脂肪肝组织FDG代谢变化的初步探讨[J]. 肿瘤影像学, 2019, 28(2): 78-83 https://doi.

org/10.19732/j.cnki.2096-6210.2019.02.003
莫奕文,李沅桦,李璐,等. 淋巴瘤患者化疗相关性脂肪肝组织FDG代谢变化的初步探讨[J]. 肿瘤影像学, 2019, 28(2): 78-83 https://doi. DOI： 10.19732/j.cnki.2096-6210.2019.02.003.

org/10.19732/j.cnki.2096-6210.2019.02.003 DOI：

摘要

目的：

初步探讨淋巴瘤患者化疗相关性脂肪肝组织18F-FDG的代谢分布变化。

方法：

纳入85例化疗前肝脏正常而化疗后出现脂肪肝的淋巴瘤患者，回顾性分析其化疗前PET/CT（PET0）和化疗后PET/CT（PET1）肝脏背景的代谢变化，记录每次PET/CT显像肝和脾的CT值，肝和纵隔血池标准摄取值（standard uptake value，SUV）、瘦体标准化摄取值（standard uptake value normalized to lean body mass，SUL），以及患者身高、体质量。脂肪肝定义为肝脏CT值42 HU，根据肝/脾CT值分为轻、中及重度脂肪肝。采用配对t检验、单因素分析及Games-Howell检验进行统计学分析。

结果：

85例患者PET0和PET1的体质量指数（body mass index，BMI）分别为22.63.9、22.63.9（

=0.828），肝脏SUVmean分别为2.210.43、1.980.51（

＜0.001），肝脏SULmean分别为 1.740.34、1.540.34（

＜0.001）。轻、中及重度脂肪肝患者分别有41、29及15例。3组的肝脏SUVmean分别为2.150.46、1.880.59 、1.680.31（

=0.004），SULmean分别为1.650.30、1.470.39、1.350.22（

=0.005）。从PET0到PET1，轻、中、重度脂肪肝组的SUVmean分别减低0.080.49、0.310.70、0.500.33（

=0.003），SULmean分别减低0.100.37、0.270.54、0.390.22（

=0.003）。两两比较，重度组比轻度组下降更明显（

=0.002）。

结论：

淋巴瘤患者化疗后脂肪肝的肝脏背景比化疗前正常肝脏减低，且脂肪肝越严重，减低越明显。

Abstract

Objective:

To determine the impact of chemotherapy-associated hepatic steatosis on liver uptake of 18F-FDG in lymphoma patients.

Methods:

Lymphoma patients who developed hepatic steatosis after the initiation of standardized chemotherapies were recruited. PET/CT scans before (PET0) and after (PET1) chemotherapy were retrospectively reviewed. The hepatic and splenic mean CT attenuation

the hepatic and mediastinal standard uptake value (SUV) and standard uptake value normalized to lean body mass (SUL)

and patients' height and body weight were recorded at PET0 and PET1 respectively. Hepatic steatosis was defined as liver CT42 HU

and then was divided into mild

moderate and severe degrees according to the ratio of hepatic CT/spleen CT. Paired t-test

one-way ANOVA test and Games-Howell test were adopted to determine the statistical differences.

Results:

A total of 85 patients were included. The values of body mass index (BMI)

liver SUVmean

and liver SULmean at PET0 and PET1 were22.63.9

22.63.9 (

=0.828)

2.210.43

1.980.51 (

＜0.001)

1.740.34

1.540.34 (

＜0.001)

respectively. Mild

moderate and severe hepatic steatosis was developed in 41

29 and 15 patients after chemotherapy. The values of SUVmean and SULmean of liver background in three groups were 2.150.46

1.880.59 vs 1.680.31 (

=0.004)

and 1.650.30

1.470.39

1.350.22 (

=0.005)

respectively. The reduction in liver FDG uptake from PET0 to PET 1 was 0.080.49

0.310.70

and 0.500.33 for SUVmean (

=0.003)

and 0.100.37

0.270.54

and 0.390.22 for SULmean (

=0.003) in mild

moderate and severe hepatic steatosis respectively. The reduction in liver background in severe hepatic steatosis was more obvious than that in mild hepatic steatosis (

=0.002).

Conclusion:

The lymphoma patients who developed hepatic steatosis after chemotherapy present with a decreased liver background in FDG PET scan. The more severe the hepatic steatosis is

the more significant the reduction is.

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