[1]郝新忠,武志芳,武萍,等.SAPHO综合征18F-FDG PET/CT显像和临床分析[J].国际放射医学核医学杂志,2015,39(6):447-451,457.[doi:10.3760/cma.j.issn.1673-4114.2015.06.003]
 Hao Xinzhong,Wu Zhifang,Wu Ping,et al.18F-FDG PET/CT imaging and clinical features of SAPHO syndrome[J].International Journal of Radiation Medicine and Nuclear Medicine,2015,39(6):447-451,457.[doi:10.3760/cma.j.issn.1673-4114.2015.06.003]
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SAPHO综合征18F-FDG PET/CT显像和临床分析(/HTML)
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《国际放射医学核医学杂志》[ISSN:1673-4114/CN:12-1381/R]

卷:
39
期数:
2015年第6期
页码:
447-451,457
栏目:
出版日期:
2015-11-25

文章信息/Info

Title:
18F-FDG PET/CT imaging and clinical features of SAPHO syndrome
作者:
郝新忠 武志芳 武萍 鄢敏 刘建中 李思进
030001 太原, 山西医科大学第一医院核医学科
Author(s):
Hao Xinzhong Wu Zhifang Wu Ping Yan Ming Liu Jianzhong Li Sijin
Department of Nuclear Medical, the First Hospital of Shanxi Medical University, Taiyuan 030001, China
关键词:
获得性骨肥大综合征正电子发射断层显像术体层摄影术X线计算机氟脱氧葡萄糖F18
Keywords:
Acquired hyperostosis syndromeBonePositron-emission tomographyTomography X-ray computedFluorodeoxyglucose F18
DOI:
10.3760/cma.j.issn.1673-4114.2015.06.003
摘要:
目的 分析滑膜炎、痤疮、掌跖脓疱病、骨肥厚、骨炎(SAPHO)综合征18F-FDG PET/CT影像及临床特征。方法 回顾性分析2011年3月至2013年8月行PET/CT检查的5例SAPHO综合征患者,并复习相关文献。诊断依据kahn标准。结果 (1)临床分析显示,5例患者以骨关节疼痛或皮肤病变就诊。2例患者伴随皮肤病变,3例患者C-反应蛋白和红细胞沉降率水平升高,1例患者人白细胞抗原B27阳性。5例患者类风湿因子、可提取性核抗原多肽抗体谱和抗中性粒细胞胞浆抗体均为阴性,平均诊断周期为3.78年。(2)PET/CT影像:5例患者均有前胸壁和脊柱受累。前胸壁受累包括胸锁关节、胸肋关节、胸骨柄体关节,共11个关节,1例锁骨肥大和骨髓炎。脊柱受累1例表现涉及单椎体,其余4例表现涉及多个椎体,共35个椎体受累,涉及58个椎体间盘连接处。CT表现为关节面或椎间盘连接面虫蚀状、孔洞状骨质破坏,周围相对广泛骨质硬化,硬化甚至涉及整个椎体。部分受累关节间隙变窄,甚至关节骨性融合。关节周围软组织的肿胀、增厚或钙化亦可被观察到。PET显像见6处前胸壁骨关节(6/11)和17处椎体间盘连接处(17/58)18F-FDG摄取增高,SUVmax为 1.76~9.74,骨硬化区和其余受累骨关节18F-FDG摄取类似或低于邻近正常同类组织。1例患者CT见锁骨肥大、骨髓炎,PET可见18F-FDG摄取,SUVmax为2.68。结论 前胸壁骨关节和脊柱是SAPHO综合征最常见受累部位,可伴有或不伴皮肤病变。PET/CT扫描能发现更多隐匿性病灶,发现活动性炎性病灶并能有效排除肿瘤。
Abstract:
Objective To analyze the 18F-FDG PET/CT imaging and the clinical features of patients with synovitis, acne, pustulosis, hyperostosis, and osteitis(SAPHO) syndrome and improved the diagnosis and awareness level about the disease. Methods This study retrospectively analyzed the PET/CT images and clinical features of five patients(including 3 females and 2 males; age range: 59-74 years old; average age: 67.2 years old) with SAPHO syndrome, as well as reviewed relevant literature. The PET/CT examinations were performed from March 2011 to August 2013. SAPHO syndrome was diagnosed through biopsy, imaging, follow-up results, and according to the Kahe Standard. Results (1) Clinic: Five patients sought treatment in the hospital for bone joint pain or skin lesions. Two of the five patients had no skin lesions, three patients exhibited elevated serum CRP and ESR levels, and one patient was positive for HLA-B27. Rheumatoid factor, extractable nuclear antigen peptide antibody spectrum and antineutrophil cytoplasmic antibodies were negative in 5 patients. The average diagnosis period was 3.78 years. (2)PET/CT imaging: Five patients showed anterior chest wall and spine involvement. Anterior chest wall involvement included 11 bone joints, such as the sternoclavicular joint, sternocostal joint, and sternal-body joint. One patient showed hypertrophy and osteomyelitis of the clavicle. Only one patient showed an involvement of a single vertebra, whereas the others showed an involvement of multiple sites of the spine, including 35 vertebra and 58 vertebral disc connections. The CT revealed the worm-eaten and hole-shaped bone destruction on the articular surface of the anterior chest wall and intervertebral disc junction. They were surrounded by relatively extensive osteosclerosis, even involving the entire vertebral body. The partially involved joints also showed joint space narrowing and even joint bone fusion. In addition, swelling, thickening, and calcification of periarticular soft tissues were observed. The PET revealed that only a part of the involved bone joints of anterior chest wall lesions(6/11) and intervertebral disc junctions(17/58) exhibited an increased 18F-FDG uptake, and the SUVmax ranged from 1.76 to 9.74. 18F-FDG uptake of the other involved bone joint lesions was similar or lower than that of the adjacent similar organization. The clavicle with hypertrophy and osteomyelitis in the patient showed an 18F-FDG uptake SUVmax of 2.68. Conclusions The anterior chest wall and spine are the common sites of involvement in SAPHO syndrome patients with or without skin lesions. 18F-FDG PET/CT scan can reveal more occult lesions and active inflammation as well as effectively exclude neoplastic lesions.

参考文献/References:

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备注/Memo

备注/Memo:
收稿日期:2015-6-11。
通讯作者:武志芳,Email:wuzhifang01@163.com
更新日期/Last Update: 1900-01-01