^(18)F-FDG PET-CT在风湿免疫系统疾病中的应用  

Application of ^(18)F-FDG PET/CT in rheumatic diseases

作　　者：王憬 张极峰[1] 于珊珊[2] 常悦[1] 于婷婷 李萍[1] Wang Jing;Zhang Jifeng;Yu Shanshan;Chang Yue;Yu Tingting;Li Ping(Division of PET/CT,the Second Hospital Affiliated of Harbin Medical University,Harbin,150086,China)

机构地区：[1]哈尔滨医科大学附属第二医院PET/CT室,黑龙江哈尔滨150086 [2]哈尔滨医科大学附属第二医院CT室,黑龙江哈尔滨150086

出　　处：《中国中西医结合影像学杂志》2019年第2期162-166,共5页Chinese Imaging Journal of Integrated Traditional and Western Medicine

摘　　要：目的 :探讨^(18)F-FDG PET-CT在风湿免疫系统疾病诊断中的应用价值。方法 :回顾性分析行PET-CT检查且经临床诊断标准证实的32例风湿免疫系统疾病患者的临床资料及^(18)F-FDG PET-CT特征,观察病灶^(18)F-FDG摄取情况。结果:32例中,痛风3例,类风湿关节炎(RA)5例,多发性大动脉炎(TA)6例,强直性脊柱炎(AS)4例,成人Still病(AOSD)9例(其中2例合并AS),皮肌炎2例,风湿性多肌痛(PMR)3例。PET-CT表现:痛风表现为患病关节邻近软组织肿胀、关节腔积液,伴FDG代谢升高;RA表现为双侧肩关节、肘关节、髋关节、腕关节及部分近端掌指关节FDG摄取升高;TA表现为主动脉及主要分支血管管壁不均匀增厚,伴FDG代谢弥漫性升高;AOSD表现为骨髓FDG弥漫性摄取升高,脾脏FDG代谢高于肝脏,全身部分淋巴结肿大伴FDG代谢升高,部分关节FDG代谢升高;皮肌炎表现为双侧肩部、双侧胸锁乳突肌、双侧臀部肌肉FDG代谢轻度升高;PMR表现为双侧肩、双髋、双膝、双踝关节、耻骨联合、坐骨结节周围FDG摄取升高;AS 4例中2例表现为骶髂关节FDG代谢升高,2例双髋FDG代谢升高。结论:^(18)F-FDG PET-CT有助于风湿免疫系统疾病的早期诊断,可准确显示病变范围。Objective:To investigate the characteristics of 18F-FDG PET/CT imaging in rheumatic diseases and its application in the diagnosis and early diagnosis of rheumatic immune system diseases.Methods:The clinical data and 18F-FDG PET/CT imaging features of 32 patients with rheumatic immune system diseases confirmed by clinical diagnostic criteria were analyzed retrospectively to observe 18F-FDG uptake of the lesions.Results:Among all the 32 patients with rheumatic diseases:3 cases with gout,5 cases with rheumatoid arthritis(RA),6 cases with takayasu arteritis(TA),9 cases with adult onset Still’s disease(AOSD)(including 2 cases with ankylosing spondylitis),2 cases with dermatomyositis(DM),3 cases with polymyalgia rheumatica(PMR),4 cases with ankylosing spondylitis(AS).Features of PET/CT:Gout showed swelling of adjacent soft tissue,effusion of articular cavity and increased metabolism of FDG.The SUVmax was 4.1.RA showed increased uptake of FDG in bilateral shoulder joints,elbow joints,hip joints,wrist joints and some proximal metacarpophalangeal joints.The SUVmax was 4.3.TA showed uneven thickening of aorta and main branches,partial calcification and diffuse increase of FDG metabolism.The SUVmax was 5.4.AOSD showed that FDG uptake increased in bone marrow,FDG metabolism in spleen was higher than that in liver,partial lymph node enlargement with FDG metabolism increased,and partial FDG metabolism increased.The SUVmax was 8.6.DM showed bilateral shoulder,bilateral sternocleidomastoid muscle and slight increase of FDG metabolism in bilateral hip muscles.The SUVmax was 4.8.PMR showed FDG uptake around bilateral shoulder,bilateral chest lock,hip,knee,ankle,pubic symphysis,lumbar spinous process,and ischium nodule.The SUVmax was 4.8.AS showed increased FDG metabolism in sacroiliac joint in 2 cases and increased FDG metabolism in 2 cases of double hip joint.The SUVmax was 3.8.Conclusion:18F-FDG PET/CT imaging is helpful to the diagnosis of rheumatic immune system diseases,and it is of great value to the early diagnosis of rhe

关 键 词：风湿性疾病 正电子发射断层显像术 氟脱氧葡萄糖F18 

分 类 号：R593.2[医药卫生—内科学] R817.4[医药卫生—临床医学]