摘要
目的:分析和探讨成人Still病(adult-onset still’s diseases,AOSD)的临床资料和18F-FDG PET/CT显像特征,以提高对该病的认识和诊断水平。方法:收集2015年11月-2018年3月经临床诊断为AOSD的患者12例,回顾性分析其临床及PET/CT影像学资料,总结肝、脾、骨髓、淋巴结等部位最大标准化摄取值(SUVmax)。结果 :本组患者实验室指标中白细胞计数(66.7%,8/12)、中性粒细胞百分比(91.7%,11/12)、血小板计数(41.7%,5/12)不同比例升高,10例患者轻~中度贫血,所有患者红细胞沉降率、C-反应蛋白、乳酸脱氢酶和血清铁蛋白均升高。10例骨髓活检提示骨髓增生活跃,6例颈部淋巴结活检提示淋巴结反应性增生。AOSD患者的18F-FDG主要摄取部位为骨髓(100%,12/12)、脾脏(91.7%,11/12)和淋巴结(91.7%,11/12),其SUVmax分别为3.2~6.7(5.0±1.0)、3.1~7.3(5.0±1.5)和3.0~16.7(8.1±4.7),淋巴结最大长径范围0.7~4.6(1.8±1.2) cm,另外在腺体、关节和胸膜等部位也可以有18F-FDG摄取。相关性分析显示骨髓SUVmax与乳酸脱氢酶、脾脏SUVmax与乳酸脱氢酶、脾脏SUVmax与血红蛋白浓度呈正相关(rs=0.599、0.629,r=0.616,P<0.05);其他部位SUVmax与实验室检查各指标之间的相关性均无统计学意义(P>0.05),受累淋巴结的SUVmax与淋巴结大小之间呈正相关(rs=0.788,P<0.01)。结论:18F-FDG PET/CT显像在AOSD的诊断和鉴别诊断中具有一定应用价值,其显像具有特征性,可以为临床诊断AOSD提供更多的证据,结合其临床表现和实验室指标有助于排除诊断、指导穿刺活检等。
Objective: To analyze and discuss the clinical data and 18F-FDG PET/CT imaging features of adult-onset still’s diseases(AOSD) for better understanding and diagnosis of the disease. Methods: A total of 12 patients with clinically diagnosed AOSD from November 2015 to March 2018 were retrospectively included. The clinical and PET/CT imaging data were analyzed. The maximum normalized uptake values(SUVmax) of liver, spleen, bone marrow, and lymph nodes were summarized.Results: The leukocyte count(66.7%, 8/12), the percentage of neutrophils(91.7%, 11/12) and the platelet count(41.7%, 5/12) of the patients in the group were increased in different proportions. 10 patients were diagnosed with mild to moderate anemia,and all with an increase in the erythrocyte sedimentation rate, C-reactive protein, lactate dehydrogenase and serum ferritin. 10 cases showed active bone marrow hyperplasia in bone marrow biopsy, and 6 cases with cervical lymph node biopsy showed reactive hyperplasia of lymph nodes. The main uptake sites of 18 F-FDG in patients with AOSD included bone marrow(100%,12/12), spleen(91.7%, 11/12), and lymph nodes(91.7%, 11/12). The SUVmax were 3.2 to 6.7(5.0±1.0), 3.1 to 7.3(5.0±1.5) and3.0 to 16.7(8.1±4.7) respectively. The maximum diameters of lymph nodes ranged from 0.7 to 4.6(1.8±1.2) cm.18 F-FDG uptake may also be present in glands, joints, and pleura. The correlation analysis showed a positive correlation between bone marrow SUVmaxand lactate dehydrogenase, spleen SUVmaxand lactate dehydrogenase, spleen SUVmaxand hemoglobin concentration(rs=0.599, 0.629, r=0.616, P<0.05). There was no statistically significant correlation between SUVmaxin other parts and various indexes of laboratory examination(P>0.05). There was a positive correlation between SUVmaxand lymph node size in affected lymph nodes(rs=0.788, P<0.01). Conclusions:18 F-FDG PET/CT imaging is valuable in the diagnosis and differential diagnosis of AOSD. The imaging features can provide more evidence for clinical diagnosis of AOSD, combinated with clinical manifestations and laboratory indicators, it will be helpful for exclusive diagnosis and puncture biopsy guiding.
作者
倪明
汪世存
刘昕
张依凡
潘博
展凤麟
NI Ming;WANG Shi-cun;LIU Xin;ZHANG Yi-fan;PAN Bo;ZHAN Feng-lin(PET/CT Center, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine,University of Science and Technology of China, Hefei 230001, China)
出处
《中国临床医学影像杂志》
CAS
2019年第5期350-354,共5页
Journal of China Clinic Medical Imaging
基金
国家自然科学基金(项目批准号:31500967)
