^18F—FDGPET／CT对皮肌炎肌肉炎性病变的评估价值  

Clinical value of ^18F-FDG PET/CT in assessing muscular inflammation of dermatomyositis

作　　者：王冬艳[1] 吴敏[2] 王跃涛[1] 邱春 邵晓梁[1] 牛荣[1] 王小松[1] Wang Dongyan;Wu Min;Wang Yuetao;Qiu Chun;Shao Xiaoliang;Niu Rong;Wang Xiaosong(Department of Nuclear Medicine,the First People＇s Hospital of Changzhou,the Third Affiliated Hospital of Soochow University,Changzhou 213003,China;Department of Rheumatology,the Affiliated Hospital of Soochow University（the First People＇s Hospital of Changzhou）,Changzhou 213003,China)

机构地区：[1]苏州大学附属第三医院、常州市第一人民医院核医学科,213003 [2]苏州大学附属第三医院、常州市第一人民医院风湿科,213003

出　　处：《中华核医学与分子影像杂志》2018年第8期532-536,共5页Chinese Journal of Nuclear Medicine and Molecular Imaging

摘　　要：目的分析皮肌炎（DM）的^18F－脱氧葡萄糖（FDG） PET/CT影像特征，探讨其对DM肌肉炎性病变的诊断价值及最大标准摄取值（SUVmax）与肌肉炎性病变活动度的关系。方法回顾性分析2013年7月至2016年11月期间住院的17例DM患者（男8例、女9例，年龄35～78岁）的18F－FDG PET/CT图像特点和临床资料，其中典型DM（TDM） 13例，无肌病性DM（ADM） 4例。选择同时间段的17例健康体检者（男8例，女9例，年龄35～78岁）作为对照组。将全身近端肢带肌群分为7个区域，测量并记录SUVmax。采用两样本t检验、单因素方差分析、Dunnett－t检验和Spearman秩相关处理数据。结果5例TDM表现为全身多发肌肉弥漫性FDG摄取增高；8例TDM表现为局部肌肉FDG摄取增高，主要为肩部和臀部肌肉；4例ADM肌肉FDG摄取视觉上与对照组无异。17例DM患者肌肉FDG摄取SUVmax由大到小为：肩背部肌肉〉臀部肌肉〉胸椎旁肌肉〉颈椎旁肌肉〉肱二头肌〉股四头肌上份〉腰椎旁肌肉；DM、TDM、ADM和对照组肌肉SUVmax分别为1.92±0.86、2.14±0.85、1.19±0.44和0.93±0.26（F＝69.50，P〈0.001），DM组高于对照组，TDM组高于ADM组，ADM组高于对照组（t值：4.102～11.970，均P〈0.05）。9例DM伴间质性肺炎（ILD）者肌肉SUVmax低于不伴ILD者（1.73±0.09与2.13±0.13；t＝5.857，P〈0.001）。DM患者肌肉SUVmax与肌酸激酶（CK）、由M和B亚基组成的肌酸激酶同工酶（CK－MB）均呈正相关（rs值：0.814和0.751，均P〈0.001）。结论^18F－FDG PET/CT可用于检测DM肌肉炎性病变；SUVmax可反映肌肉炎性病变活动度和严重程度，并可评估其伴发的ILD情况。ObjectiveTo analyze the imaging characteristics and diagnostic value of ^18F-fluorodeoxyglucose （FDG） PET/CT in muscular inflammation in dermatomyositis （DM）, as well as the relationship between maximum standardized uptake value （SUVmax） and activity of muscular inflammation.MethodsFrom July 2013 to November 2016, 17 hospitalized DM patients （8 males, 9 females, age range： 35-78 years） who underwent 18F-FDG PET/CT were retrospectively reviewed, including 13 typical DM （TDM） and 4 amyopathic DM （ADM）. Seventeen healthy volunteers （8 males, 9 females, age range： 35-78 years） in the same period were enrolled as the control group. The proximal limb muscles of whole body were divided into 7 areas, and the SUVmax of each was measured and recorded. Two-sample t test, one-way analysis of variance, Dunnett-t test and Spearman correlation analysis were used to analyze data.ResultsFive TDM cases showed diffuse increased FDG uptake in global muscles; 8 TDM cases showed increased FDG uptake in local muscles, mainly in the shoulder and hip. The FDG uptake by muscles of 4 ADM patients was similar with that of controls. The SUVmax was lower and lower in the order of shoulder and back muscles, hip muscles, thoracic vertebra muscles, cervical vertebra muscles, biceps, proximal quadriceps and lumbar vertebra muscles in DM group. The muscle SUVmax of DM, TDM, ADM and the controls were 1.92±0.86, 2.14±0.85, 1.19±0.44 and 0.93±0.26, respectively （F=69.50, P〈0.001）. Muscle SUVmax of DM group was higher than that of controls, muscle SUVmax of TDM was higher than that of ADM, and muscle SUVmax of ADM was higher than that of controls （t values： 4.102-11.970, all P〈0.05）. Muscle SUVmax of 9 DM patients with interstitial lung disease （ILD） was lower than that of patients without ILD （1.73±0.09 vs 2.13±0.13; t=5.857, P〈0.001）. Muscle SUVmax of DM was positive correlated with serum levels of creatine kinase （CK） and creatine kinase isoenzyme composed by M and B subunits （CK-M

关 键 词：皮肌炎 正电子发射断层显像术 体层摄影术 X线计算机 脱氧葡萄糖 

分 类 号：R816[医药卫生—放射医学] R593.26[医药卫生—临床医学]