目的：分析18F-FDG PET/CT在成人Still病（adult-onset still’s diseases，AOSD）中的诊断价值及其在PET/CT中的表现特点。方法：采用1992年日本成人Still病研究委员会提出的诊断标准。回顾分析解放军总医院风湿科50例AOSD患者的PET/CT影像及临床资料，总结PET/CT在该病中的影像学特点及其优势。结果：50例AOSD患者中，均未发现实体恶性肿瘤。肝脏、脾脏、骨髓、淋巴结、关节及腺体均有不同程度的FDG高摄取。骨髓FDG摄取41例，SUVmax平均值为3.60±1.02，其中29例行骨髓穿刺活检；淋巴结FDG摄取30例，SUVmax平均值为5.86±3.79，同机CT测量最大直径约为0.68~2.54 cm，其中9例行淋巴结穿刺活检，病理均提示淋巴组织增生；脾脏、肝脏、关节及腮腺FDG摄取分别为39例、11例、5例、14例，SUVmax平均值分别为3.35±0.94、2.56±0.66、2.46±0.81及2.37±0.79，其中同机CT测量肝右叶最大斜径约为14.2~23.5 cm。50例AOSD患者中，皮下均未见结节及FDG摄取增高。结论：全身18F-FDG PET/CT显像在AOSD诊断中起着重要的作用，且AOSD患者PET/CT具有一定的特征性表现，有助于排除恶性疾病，指导穿刺活检及临床决策。
Abstract
Objective: To analysis the diagnostic value of 18F-FDG PET/CT in adult-onset still’s diseases(AOSD) and its characteristics in PET/CT. Methods: According to the diagnostic criteria of 1992 in adult-onset still’s diseases research committee of Japan, the clinical data and PET/CT images of 50 patients with AOSD were retrospectively analyzed in rheumatology department of the PLA general hospital. We summarized characteristics and advantages in the PET/CT imaging of AOSD. Results: Among the 50 AOSD patients, no patient was found with solid malignant tumors. Various degrees of FDG uptake were found in liver, spleen, bone marrow, lymph nodes, joint and glands. Uptake in Bone marrow was seen in 41 patients(SUVmax: 3.60±1.02), 29 of which had undergone bone marrow biopsy. Uptake in lymph node was seen in 30 patients(SUVmax: 5.86±3.79), 9 of which had undergone lymph node biopsy, and all of the pathological results turned out to be lymphoid tissue hyperplasia. Maximum diameters of lymph nodes which were measured in transverse CT images were 0.68~2.54 cm. Uptake in spleen(SUVmax: 3.35±0.94), liver(SUVmax: 2.56±0.66), joints(SUVmax: 2.46±0.81) and gland(SUVmax: 2.37±0.79) was seen in 39, 11, 5 and 14 patients. Maximum diameters obliqua of right lobe of liver which were measured in transverse CT images were 14.2~23.5 cm. No significant FDG uptake and subcutaneous nodules were found in all of the 50 AOSD patients. Conclusion: Whole body 18F-FDG PET/CT performs an important role in diagnosis of AOSD. Characteristic manifestations in 18F-FDG PET/CT help to exclude malignant diseases or to guide the biopsy and clinical management of ASOD.
关键词
/
Still病 /
成年型 /
正电子发射断层显像术 /
体层摄影术 /
螺旋计算机
Key words
Still’s disease, adult-onset /
Positron-emission tomography /
Tomography, spiral computed
中图分类号：
Ｒ593.2
Ｒ817.4
R814.42
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