目的：探讨滑膜炎、痤疮、脓疱病、骨肥厚及骨炎综合征（Synovitis, acne, pustulosis, hyperostosis, and osteitis，SAPHO）累及脊柱的影像表现，以提高对此病的认识。方法：26例SAPHO患者中男16例，女10例，年龄26～73岁，平均（48.5±12.5）岁。对26例临床确诊SAPHO患者的临床和影像资料进行回顾，分析病变累及脊柱的CT和MRI表现形式。结果：19例累及脊柱占73%，胸椎、腰椎及颈椎受累的例数分别为13、10和6例，同时累及颈胸椎及胸腰椎的各为5例。累及椎体的节段数2～10个椎体不等，平均（3.4±0.8）个椎体。连续累及2个及以上椎体9例。11例椎体合并骨髓水肿，8例合并椎体骨侵蚀，9例合并骨硬化。终板受累10例表现为上下终板形态不规则。6例表现为间盘信号增高，3例椎间隙狭窄。椎旁软组织增厚4例，椎旁韧带骨化2例。胸锁、胸肋、肋骨和骶髂关节受累也相对多见。结论：SAPHO累及脊柱不少见，以胸椎受累相对常见，其次是腰椎和颈椎，连续累及2个及以上椎体的常见，其它部位以胸锁关节最常见。影像表现多样，需多种方法联合。
Abstract
Objective: To explore imaging features of synovitis, acne, pustulosis, hyperostosis, and osteitis(SAPHO) syndrome with vertebral involvement. Methods: Clinical and imaging data of 26 cases(16 male and 10 female; age between 26 to 73 years old, mean age (48.5±12.5) years) clinically confirmed as SAPHO syndrome were analyzed retrospectively. Imaging features of CT and MRI were described. Results: The number of thoracic, lumbar and cervical spine involved was 13, 10 and 6 respectively. Five cases had cervical-thoracic or thoracic-lumbar involvement. The number of spine involvement was between 2 to 10 and mean value was 3.4±0.8. Contiguous involvement of 2 vertebral bodies or more was found in 9 cases. Edema of vertebra body was found in 11 cases and bone erosion and bone sclerosis were present in 8 and 9 cases, respectively. Endplate irregularity was found in 10 cases. Six cases showed T2 hyperintensity in intervertebral discs and three cases showed narrowed intervertebral space. Thickened paraspinal soft-tissue was present in 4 cases and calcification of ligament was present in 2 cases. Other involvement locations included sternoclavicular, sternocostal joint, rib and sacroiliac joint and these are commonly seen SAPHO. Conclusion: SAPHO with spine involvement is not rare and thoracic is the most commonly involved segment, with lumbar and cervical segment following. Contiguous involvement of two or more segments is commonly seen and other commonly involvement location is sternoclavicular joint. Imaging appearance is diverse and several methods are needed to detect all of these lesions.
关键词
获得性骨肥大综合征 /
脊柱 /
体层摄影术 /
螺旋计算机 /
磁共振成像
Key words
Acquired hyperstosis syndrome /
Spine /
Tomography, spiral computed /
Magnetic resonance imaging
中图分类号：
Ｒ681.5
Ｒ814.42
Ｒ445.2
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