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学科主题: 核医学
题名:
SAPHO综合征25例99Tcm -MDP全身骨显像分析
其他题名: 99Tcm-MDP whole body bone imaging in 25 patients with SAPHO syndrome
作者: 付占立; 范岩; 张建华; 廖栩鹤; 林景辉; 王荣福
关键词: 获得性骨肥大综合征 ; 放射性核素显像 ; MDP ; Accquired hyperostosis sydrome ; Radionuclide imaging ; MDP
刊名: 中华核医学杂志
发表日期: 2011
DOI: 10.3760/cma.j.issn.0253-9780.2011.05.012
卷: 31, 期:5, 页:324-327
收录类别: 中文核心期刊
文章类型: Journal Article
摘要: 目的 分析滑膜炎、痤疮、脓疱病、骨肥厚、骨炎综合征(即SAPHO综合征)99Tcm-MDP全身骨显像的影像特点,评价骨显像在SAPHO综合征中的应用价值.方法 回顾分析25例确诊为SAPHO综合征患者的临床、骨显像及其他影像学资料,将骨骼病变部位分为前胸壁(包括锁骨、胸骨以及胸锁关节、肋胸连接、胸骨柄体连接)、脊柱、下颌骨、骶髂关节以及四肢骨,总结SAPHO综合征骨显像特点,并与其他影像学结果进行比较.结果 25例患者中,32% (8/25)合并有皮肤损害;48%( 12/25)骨活组织检查证实为慢性非特异性炎性反应.骨显像发现全部患者均有前胸壁受累,胸肋锁骨关节和连接受累率为96%( 24/25),其中胸锁关节、第一肋胸连接以及胸骨柄体连接的受累率分别为60%( 15/25)、48%( 12/25)和44%( 11/25),但骨显像呈典型“牛头”征表现的患者仅有20%(5/25);脊柱及四肢骨受累率分别为44% (11/25)和16% (4/25).骨显像发现68%( 17/25)患者有隐匿性病灶,主要分布在第一肋胸连接、胸锁关节、胸骨柄体连接和脊柱.结论 胸肋锁骨关节和连接受累为SAPHO综合征的影像特点,结合临床及其他影像学资料,99Tcm-MDP全身骨显像可用于SAPHO综合征患者的诊断与鉴别诊断、发现隐匿病灶以及评价病灶活性. Objective To investigate the usefulness of 99Tcm-MDP whole body bone scintigraphy (WBBS) in patients with synovitis,acne,pustulosis,hyperostosis,osteitis (SAPHO) syndrome.Methods 99Tcm- MDP WBBS was performed in 25 patients (6 males,19 females,mean age =(55.1 ±9.8) years)with SAPHO syndrome.Bone lesions were classified into five categories:anterior chest wall,spine,mandible,sacroiliac joint,and limbs.The typical scintigraphic manifestations of SAPHO syndrome were summarized and compared to other radiological imaging data.Results Among 25 patients,32% of cases (8/25)were associated with skin lesion; 48% ( 12/25 ) were pathologically diagnosed with chronic nonspecific bone inflammation by bone biopsy.On 99Tcm-MDP WBBS,abnormal metabolic foci at anterior chest wall were found in all cases,most of which located in the sternocostoclavicular region (96%,24/25 ),including sternoclavicular joints (60%,15/25),first costosternal junctions (48%,12/25),and manubriosternal junctions (44%,11/25 ).Only 20% of the patients (5/25) demonstrated the typical scintigraphic characteristic:“bull's head” sign.The second most frequent part was spine (44%,11/25).Appendicular skeleton was affected in 16% (4/25) patients.WBBS also demonstrated additional skeletal lesions in 68% (17/25 ) of the patients,mainly in first costosternal junctions (7 patients),sternoclavicular joints (6 patients),manubriosternal junctions (5 patients) and spine (4 patients).Conclusions Abnormal metabolic foci in sternocostoclavicular region and other imaging manifestations on 99Tcm- MDP WBBS can be used to diagnose,differentiate,and localize the insidious lesion and evaluate the lesion activity in patients with SAPHO syndrome.
语种: 中文
原文出处: 查看原文
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内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/43005
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作者单位: 100034,北京大学第一医院核医学科
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