MRI与CT在SAPHO综合征诊断中的应用分析  

Analysis of the use of MRI and CT in the diagnosis of SAPHO syndrome

作　　者：谭华清 鲍海华[1] 曹云太 夏弘婧 付诗晗 TAN Huaqing;BAO Haihua;CAO Yuntai;XIA Hongjing;FU Shihan(Imaging Center,Affiliated Hospital of Qinghai University,Xining 810000,China;CT Department,Qinghai Provincial People'sHospital,Xining 810000,China)

机构地区：[1]青海大学附属医院影像中心,西宁810000 [2]青海省人民医院CT室,西宁810000

出　　处：《磁共振成像》2023年第11期108-112,共5页Chinese Journal of Magnetic Resonance Imaging

基　　金：青海省“昆仑英才•高端创新创业人才”计划项目(编号:青人才字〔2021〕13号);青海省科技计划项目(编号:2023-ZJ-918M)。

摘　　要：目的探讨SAPHO(synovitis-acne-pustulosis-hyperostosis-osteitis)综合征患者的病程时间长短与胸骨柄肥大之间的关系,并分析其影像学特征。材料与方法回顾性分析我院2021年1月至2022年9月诊断的24例SAPHO综合征患者的影像及临床资料,对轴向骨骼受累部位进行了CT和MRI检查,包括前胸部、脊柱和骶髂关节。将患者按病程时间划分为≤5年组14例、>5年组10例,在胸部CT图像上对胸骨柄进行测量,探讨病程时间长短与胸骨柄肥大的关系。结果24例患者累及部位包括前胸壁、脊柱和骶髂关节;前胸壁骨质硬化、骨质侵蚀病变的出现率高于脊柱,差异有统计学意义(P=0.017,P=0.030),脊柱脂肪沉积病变的出现率高于前胸壁、骶髂关节,差异有统计学意义(P=0.001,P=0.017);病程时间>5年的患者在胸骨柄厚度、胸锁关节受累率上高于病程时间≤5年的患者,差异有统计学意义(P=0.023,P=0.020);胸骨柄宽度(r^(2)=0.003,P=0.815)和胸骨柄厚度(r^(2)=0.035,P=0.379)的变化与病程无相关性。结论SAPHO综合征骨质硬化和骨质侵蚀病变在前胸壁的发生率更高,脂肪沉积病变在脊柱中更常见。病程时间长更易导致胸骨柄厚度的变化,胸锁关节受累可能是病程长的标志。Objective:To investigate the relationship between duration of illness and sternal stalk hypertrophy in patients with synovitis-acne-pustulosis-hyperostosis-osteitis(SAPHO)syndrome and to analyze their imaging features.Materials and Methods:Imaging and clinical data of 24 patients with SAPHO syndrome diagnosed in our hospital from January 2021 to September 2022 were retrospectively analyzed.CT and MRI were performed on axial skeletal involvement,including the anterior thorax,spine,and sacroiliac joints.The patients'disease duration was classified as≤5 years and>5 years,divided into 14 cases and 10 cases.Measurements of the sternal stalk were made on chest CT images to explore the relationship between the duration of the disease and the hypertrophy of the sternal stalk.Results:The sites of involvement in 24 patients included the anterior chest wall,spine and sacroiliac joints.The main types of lesions included osteosclerosis,bone erosion,bone marrow edema,and fat deposition.The incidence of osteosclerosis and bone erosion lesions in the anterior chest wall was higher than that in the spine,and the difference was statistically significant(P=0.017,P=0.030),and the incidence of fat deposition lesions in the spine was higher than that in the anterior chest wall and sacroiliac joints,and the difference was statistically significant(P=0.001,P=0.017).Patients with a disease duration of>5 years had higher rates of sternal stalk thickness and sternoclavicular joint involvement than those with a disease duration of≤5 years,and the difference was statistically significant(P=0.023,P=0.020).The changes in sternal stem width(r^(2)=0.003,P=0.815)and sternal stem thickness(r^(2)=0.035,P=0.379)were not correlated with the course of the disease.Conclusions:The types of lesions in SAPHO syndrome are complex,with osteosclerotic and bony erosive lesions being more prevalent in the anterior chest wall and fat deposition lesions being more common in the spine.A long course of the disease is more likely to lead to a change of sternal

关 键 词：SAPHO综合征 轴向骨骼病变 掌跖脓疱病 计算机断层扫描 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R593.2[医药卫生—诊断学]