PET-CT联合骨显像对SAPHO综合征的诊断价值  

The diagnostic value of PET-CT combined with bone imaging in SAPHO syndrome

作　　者：陆国秀[1] 郝珊瑚[1] 王志国[1] 郭佳[1] 陈兰兰[1] 张文文[1] 刘雨宁[1] 王秋[1] 张国旭[1] 

机构地区：[1]沈阳军区总医院核医学科,辽宁沈阳110016

出　　处：《临床皮肤科杂志》2014年第9期536-539,共4页Journal of Clinical Dermatology

摘　　要：目的:探讨.PET-CT联合骨显像在滑膜炎、痤疮、脓疱病、骨肥厚、骨髓炎(SAPHO)综合征诊断中的临床价值。方法:回顾性分析该院2006年1月一2013年6月临床怀疑SAPHO综合征的25例患者临床资料,所有患者确诊前均进行氟代脱氧葡萄糖(^(18)F-FDG)PET-CT联合^(99m)锝标记的亚甲基二膦酸盐(^(18)Tc-MDP)骨显像。分析比较PET-CT联合骨显像在SAPHO综合征诊断中的灵敏度、特异度、阳性预测值及阴性预测值。分析SAPHO综合征患者PET-CT显像中放射性最大摄取值(SUVmax)及其与红细胞沉降率(ESR)、C反应蛋白(CRP)水平的相关性。结果:25例临床怀疑SAPHO综合征患者,最终22例经临床表现及组织病理确诊为SAPHO综合征,2例为骨转移瘤,1例为多发性骨髓瘤。骨显像确诊15例患者,26个部位出现放射性浓聚。PET-CT显像发现18例患者51个部位存在不同程度代谢增高,且急、慢性炎症及陈旧性病灶,代谢差异具有统计学意义(F=4.54,P<0.05)。PET-CT联合骨显像共同确诊21例,其中发现61个病灶,PET-CT联合骨显像诊断SAPHO综合征诊断准确性明显高于前两者,差异具有统计学意义(x^2=10.54,P<0.05)。SUVmax与ESR、CRP水平呈正相关(r_1=0.82,r_2=0.72;P<0.05)。结论:PET-CT联合骨显像,可以明显提高SAPHO综合征诊断的准确性。Objective： To evaluate the importance of ISF-FDG PET-CT with ^99mTc-MDP bone imaging in the diagnosis of synovitis-acne-pustulosis-hyperostosis-osteomyelitis （SAPHO） syndrome. Methods： Twenty-five patients suspected with SAPHO syndrome were collected from January 2006 to June 2013. All patients underwent 18F-FDG PET-CT and ^99mTc-MDP bone imaging scanning to confirm the diagnosis. The sensitivity, specificity, positive predictive value and negative predictive value of PET-CT combined with bone imaging in the diagnosis of SAPHO syndrome were analyzed. Meanwhile the correlation between the maximum standardized uptake value （SUVmax） and both ESR and CRP were analyzed. Results： According to clinical manifestations and histopathological findings, SAPHO syndrome was confirmed in 22 cases while 2 cases were bone metastasis and 1 case was multiple myeloma. Bone imaging confirmed 15 cases of SAPHO syndrome with radioactivity in 26 sites. PETCT showed 51 sites with increased metabolism in 18 cases of SAPHO syndrome. The metabolic differences varied statistically among acute, chronic inflammation and the old lesions （F=4.54, P〈0.05）. PET-CT combined with bone imaging confirmed 21 cases and 61 lesions. The diagnostic accuracy of PET-CT combined with bone imaging was higher than that of either PET-CT or bone imaging alone （X^2=10.54, P〈0.05）. SUVmax was positively correlated with both ESR and CRP（rl=0.82;r2=0.72; P〈 0.05）. Conclusion： PET-CT with bone imaging could increase the diagnostic accuracy of SAPHO syndrome, and PET-CT may play an important role in the clinical classification of the SAPHO syndrome.

关 键 词：SAPHO综合征 PET—CT ^99mTc—MDP骨显像 

分 类 号：R751[医药卫生—皮肤病学与性病学]