摘要
目的分析滑膜炎、痤疮、脓疱病、骨肥厚、骨炎综合征（即SAPHO综合征）99Tcm．MDP全身骨显像的影像特点，评价骨显像在SAPHO综合征中的应用价值。方法回顾分析25例确诊为SAPHO综合征患者的临床、骨显像及其他影像学资料，将骨骼病变部位分为前胸壁（包括锁骨、胸骨以及胸锁关节、肋胸连接、胸骨柄体连接）、脊柱、下颌骨、骶髂关节以及四肢骨，总结SAPHO综合征骨显像特点，并与其他影像学结果进行比较。结果25例患者中，32％（8／25）合并有皮肤损害；48％（12／25）骨活组织检查证实为慢性非特异性炎性反应。骨显像发现全部患者均有前胸壁受累，胸肋锁骨关节和连接受累率为96％（24／25），其中胸锁关节、第一肋胸连接以及胸骨柄体连接的受累率分别为60％（15／25）、48％（12／25）和44％（11／25），但骨显像呈典型“牛头”征表现的患者仅有20％（5／25）；脊柱及四肢骨受累率分别为44％（11／25）和16％（4／25）。骨显像发现68％（17／25）患者有隐匿性病灶，主要分布在第一肋胸连接、胸锁关节、胸骨柄体连接和脊柱。结论胸肋锁骨关节和连接受累为SAPHO综合征的影像特点，结合临床及其他影像学资料，99Tcm--MDP全身骨显像可用于SAPHO综合征患者的诊断与鉴别诊断、发现隐匿病灶以及评价病灶活性。
Objective To investigate the usefulness of 99Tem-MDP whole body bone scintigraphy （WBBS） in patients with synovitis, acne, pustulosis, hyperostosis, osteitis （SAPHO） syndrome. Methods 99Tcm- MDP WBBS was performed in 25 patients （6 males, 19 females, mean age = （55.1±9.8） years） with SAPHO syndrome. Bone lesions were classified into five categories： anterior chest wall, spine, mandi- ble, sacroiliac joint, and limbs. The typical scintigraphic manifestations of SAPHO syndrome were summa- rized and compared to other radiological imaging data. Results Among 25 patients, 32% of cases （8/25） were associated with skin lesion; 48% （12/25） were pathologically diagnosed with chronic nonspecific bone inflammation by bone biopsy. On 99Tcm-MDP WBBS, abnormal metabolic foci at anterior chest wall were found in all cases, most of which located in the sternocostoclavicular region （96% , 24/25 ）, including ster- noclavicular joints （60%, 15/25）, first costosternal junctions （48%, 12/25）, and manubriosternal junc- tions （44%, 11/25 ）. Only 20% of the patients （5/25） demonstrated the typical scintigraphic characteris- tic： ＂bull＇s head＂ sign. The second most frequent part was spine （44%, 11/25）. Appendicular skeleton was affected in 16% （4/25） patients. WBBS also demonstrated additional skeletal lesions in 68% （17/ 25） of the patients, mainly in first costosternal junctions （7 patients）, sternoclavicular joints （6 patients）, manubriosternal junctions （5 patients） and spine （4 patients）. Conclusions Abnormal metabolic foci in sternocostoclavicular region and other imaging manifestations on 99Tcm- MDP WBBS can be used to diag- nose, differentiate, and localize the insidious lesion and evaluate the lesion activity in patients with SAPHO syndrome.
出处
《中华核医学杂志》
CAS
CSCD
北大核心
2011年第5期324-327,共4页
Chinese Journal of Nuclear Medicine
