摘要
目的：总结滑膜炎、痤疮、脓疱病、骨肥厚、骨炎（ SAPHO）综合征的99 Tcm-MDP全身骨显像及SPECT／CT影像特点，探讨SPECT／CT在SAPHO综合征诊断中的作用。方法回顾性分析2009年至2014年间6例SAPHO综合征患者（男1例，女5例，平均年龄63岁；病程1个月～7年）的骨显像及SPECT／CT断层显像资料，其中3例患者骨显像后进行了胸锁关节活组织检查。总结SAPHO综合征的全身骨显像及SPECT／CT的影像特点。结果6例患者胸锁关节区骨代谢均升高，其中2例为对称性。 SPECT／CT发现6例患者共8个受累胸锁关节，其中6个以关节侵蚀为主要表现；3例伴胸锁关节周围软组织肿胀；4例伴胸锁关节外病变16处，依次为胸骨及胸骨柄与胸骨体连接处、骶髂关节、椎体、耻骨、胸肋关节、肋骨、颅骨及足。胸骨外病变以骨关节侵蚀破坏为主要表现。结论SPECT／CT可发现SAPHO典型的胸锁关节侵蚀及更多的胸锁关节外病变，能够提高对SAPHO综合征的诊断准确性。
Objective To investigate the imaging characteristics of 99 Tcm-MDP bone SPECT/CT imaging in patients with synovitis, acne, pustulosis, hyperostosis, osteitis （ SAPHO） syndrome, and to e-valuate its diagnostic value. Methods 99 Tcm-MDP whole-body bone scan and SPECT/CT imaging were performed in 6 patients （ 1 male, 5 females, average age 63 years） with SAPHO syndrome （ duration：1 month to 7 years） from 2009 to 2014. Three patients underwent biopsy in sternoclavicular joint. Characteris-tics of 99 Tcm-MDP bone scan and SPECT/CT imaging were investigated. Results 99 Tcm-MDP whole-body bone scan detected high radioactivity in sternoclavicular joints of all patients, 2 cases were affected bilateral-ly and presented typical＂bull horn＂ sign, the other 4 cases were unilaterally. A total of 8 affected sternocla-vicular joints were found, and 6 of which showed articular erosion. Three patients had soft tissue swelling. Four patients had 16 additional lesions （ sternum, sacroiliac joint, vertebral, pubis, sternocostal joint, rib, skull and foot） besides the diseased sternoclavicular joints, and erosion was the main imaging feature of these non-sternoclavicular lesions. SPECT/CT imaging also found sacroiliac joint sclerosis and spine ankylo-sis without abnormal increased uptake. Conclusion SAPHO syndrome has typical imaging characteristics in the sternoclavicular region, and SPECT/CT imaging can reveal its underlying changes and detect addi-tional lesions besides the sternoclavicular region, thus can improve the diagnostic accuracy.
出处
《中华核医学与分子影像杂志》
CAS
北大核心
2015年第6期474-477,共4页
Chinese Journal of Nuclear Medicine and Molecular Imaging
