成人Still病的18F-FDG PET/CT表现特点  

8F-FDG PET/CT imaging characteristics of adult-onset Still’s disease

作　　者：李翠翠[1] 汪长银[1] 陈玲珑 徐海波[1] LI Cui-cui;WANG Chang-yin;CHEN Ling-long;XU Hai-bo(Department of Radiology,Zhongnan Hospital of Wuhan University,Hubei 430071,China)

机构地区：[1]武汉大学中南医院影像科,湖北武汉430071

出　　处：《影像诊断与介入放射学》2020年第3期201-206,共6页Diagnostic Imaging & Interventional Radiology

摘　　要：目的总结成人Still病(AOSD)18F-脱氧葡萄糖(FDG)PET/CT的成像特征,并与淋巴瘤比较,从而提高18F-FDG PET/CT在本病诊断及鉴别诊断中的价值。方法回顾性分析我院9例临床确诊为AOSD的患者,总结AOSD的主要18F-FDG PET/CT表现特点,并分析主要受累部位最大标准化摄取值(SUVmax)与主要实验室指标的相关性。比较淋巴瘤与AOSD在PET/CT上的表现异同;并采用受试者工作特征曲线(ROC)明确部分PET/CT特征诊断AOSD与淋巴瘤的效能及最佳临界点。结果AOSD在PET/CT上主要表现为骨髓(8/9,88.9%)、脾脏(8/9,88.9%)、淋巴结(9/9,100%)FDG摄取增高,还可见关节(3/9,33.3%)、颌下腺(2/9,22.2%)和肌肉(1/9,11.1%)FDG摄取增高;同次CT可见脾大(5/9,55.6%),胸腔、盆腔及心包积液(2/9,22.2%);相关性分析表明骨髓、脾脏、淋巴结SUVmax与主要实验室指标无显著相关性(P>0.05),但受累淋巴结SUVmax与淋巴结最大短径之间呈正相关(r=0.670,P=0.048)。与淋巴瘤相比,AOSD患者受累淋巴结最大短经明显较小(P<0.05),受累淋巴结SUVmax显著较低(P<0.05)。ROC曲线分析AOSD与淋巴瘤组受累淋巴结最大短经及淋巴结SUVmax结果:曲线下面积(AUC)分别为0.708、0.773,鉴别两组的最佳临界点分别为19、12。结论PET/CT在AOSD的器官受累、疾病分布情况、诊断及鉴别诊断等方面提供了丰富的影像学依据。Objective To differentiate the 18F-deoxyglucose(FDG)PET/CT imaging characteristics of adult-onset Still’s disease(AOSD)from that of lymphoma.Methods 18F-FDG PET/CT of 9 patients with AOSD was retrospective analyzed.The maximum standard uptake values(SUVmax)of the affected areas were correlated with main indexes of laboratory examinations.The imaging characteristics of lymphoma and AOSD were compared and receiver operating characteristic(ROC)curve was used to determine the efficacy and cutoff point of 18F-FDG PET/CT features in the differential diagnosis.Results AOSD was mainly manifested as increased FDG uptake in the bone marrow(8/9,88.9%),spleen(8/9,88.9%)and lymph nodes(9/9,100%)and sometimes in the joints(3/9,33.3%),submandibular glands(2/9,22.2%)and muscles(1/9,11.1%).CT showed enlargement of the spleen(5/9,55.6%),pleural effusion and ascites(2/9,22.2%).There were no significant correlation between SUVmax of the affected areas and the main indexes of laboratory examinations(P>0.05).There was positive correlation between the SUVmax and the largest short diameter of affected lymph nodes(r=0.670,P=0.048).Compared to lymphoma,the largest short diameter of the affected lymph nodes in AOSD was significantly smaller(P<0.05)and the SUVmax was significantly lower(P<0.05).The area under ROC curve(AUC)was 0.708 at optimal cutoff of 19 for the maximum short diameter compared to AUC of 0.773 at optimal cutoff of 12 for the SUVmax of the affected lymph nodes in differential diagnosis of AOSD and lymphoma.Conclusion 18F-FDG PET/CT imaging characteristics are useful for differential diagnosis of AOSD and lymphoma.

关 键 词：Still病 成年型 氟代脱氧葡萄糖 正电子发射断层成像/X线计算机体层成像 

分 类 号：R593.2[医药卫生—内科学]