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目的 探讨基于SPECT/CT定量测量99Tcm-亚甲基二膦酸盐(MDP)骨显像腰椎标准摄取值(SUV)的方法.方法 回顾性分析2017年5月至11月间行99Tcm-MDP全身骨显像和局部腰椎SPECT/CT显像的90例[男16例、女74例;年龄(60.0±11.2)岁]患者资料,均采用三维有序子集 最大期望值法(3D-OSEM)重建图像,行衰减校正和散射校正.根据重建图像中腰椎MDP高摄取病灶患者(分为退行性改变和恶性肿瘤骨转移)和腰椎无MDP高摄取病灶患者(分为骨质疏松组和非骨质疏松组)L1～L4椎体的放射性计数,分别计算各椎体及病灶单位体积的放射性活度,并将其转换为 SUV,采用两样本t检验比较不同类别患者腰椎及病灶SUV的差异,用Pearson相关分析腰椎SUV与不同指标的相关性.结果 54例腰椎无MDP高摄取病灶患者的L1～L4椎体平均SUV(SUVmean)和最大SUV(SUVmax)分别为4.64±1.03和7.09±1.61,其与骨矿物含量、CT值和体质量均呈正相关(r值:0.433～0.700,均P<0.05),与年龄均呈负相关(r值:-0.514和-0.456,均P<0.001).54例中骨质疏松组患者的腰椎SUVmean和SUVmax分别为3.81±0.76和5.86±1.34,明显低于非骨质疏松组患者(5.13±0.84和7.82±1.30;t值:-5.892和-5.240,均P<0.001).在16例患者中发现37个腰椎转移病灶,其 SUVmean和 SUVmax分别为16.40±6.07和24.25±11.35,明显高于退行性改变(20例患者27个病灶)的相应值(9.30±3.16和13.48±5.21;t值:6.074和5.083,均P<0.001).结论 基于特定重建算法和校正方法的 SPECT/CT定量测量可以获得99Tcm-MDP骨显像腰椎SUV,并能真实反映其骨盐代谢状态.“,”Objective To explore the quantitative determination of standardized uptake value(SUV)of lumbar vertebra by 99Tcm-methylene diphosphonate(MDP)bone imaging with SPECT/CT.Methods A total of 90 patients(16 males,74 females,age:(60.0±11.2)years)who underwent 99Tcm-MDP bone imaging and local lumbar SPECT/CT imaging from May 2017 to November 2017 were retrospectively analyzed.CT attenuation correction,scatter correction and 3-dimensional ordered subset expectation maximization(3D-OSEM)reconstruction were used.The radioactive counts of lumbar vertebra LL-L4 in patients with high MDP-uptake(including degenerative changes and bone metastases)and patients with non-high MDP-uptake(including osteoporosis and non-osteoporosis)were measured.Basing on that,the radioactivity of unit volume in lumbar and lesion was calculated and converted to SUV.The difference of SUV for lumbar and lesions from different types of patients was analyzed,and the correlation between lumbar SUV and varies of parameters were also analyzed.Data were analyzed by two-sample t test and Pearson correlation analysis.Results The mean SUV(SUVmean)and maximum SUV(SUVmax)of L1-L4 in 54 patients with non-high MDP-uptake were 4.64±1.03 and 7.09±1.61 respectively.They were positively correlated with bone mineral content,CT value and body weight(r values:0.433-0.700,all P<0.05),and negatively correlated with age(r values;-0.514 and -0.456,both P<0.001).The SUVmean and SUVmax of patients with osteoporosis were 3.81±0.76 and 5.86±1.34 respectively,which were significantly lower than those of non-osteoporosis(5.13±0.84 and7.82±1.30;t values:-5.892 and-5.240,both P<0.001).The SUVmean and SUVmax of 37 metastases were 16.40±6.07 and 24.25±11.35 respectively in 16 patients,which were significantly higher than those in patients with degenerative changes(20 patients with 27 lesions;9.30±3.16 and 13.48±5.21;t values:6.074 and 5.083,both P<0.001).Conclusion Based on the specific reconstruction algorithm and correction method,the SUV of lumbar vertebra on 99Tcm-MDP SPECT/CT bone imaging can be obtained,and the bone mineral metabolism can be reflected.