滑膜炎、痤疮、脓疱病、骨肥厚、骨炎综合征99mTc-MDP全身骨显像分析

目的 探讨^99mTc-MDP全身骨显像诊断滑膜炎、痤疮、脓疱病、骨肥厚、骨炎(SAPHO)综合征的临床价值。方法 回顾性分析12例SAPHO综合征患者的骨显像特点。与X线平片、CT及MRI比较,分析骨显像对SAPHO综合征诊断的价值。结果 12例患者中均见前胸壁骨质受累,典型"牛头"征改变的仅25.00%(3/12),其余表现为不完全"牛头"征或单侧"牛角"征。脊柱受累6例,4例累及椎体,其中3例累及邻近多个椎体;2例累及椎间小关节,呈比邻分布。3例骨显像所见病灶在X线平片上未见异常,而在其他影像学检查均有异常改变。结论 典型"牛头"征或不完全"牛头"征、"牛角"征是SAPHO综合征在骨显像中的特征性表现,有利于早期诊断本病及评价病情。

99mTc-MDP whole body bone imaging in diagnosis of synovitis, acne, pustulosis, hyperostosis and osteitis syndrome

Objective To explore the value of ^99mTc-MDP imaging in diagnosis of synovitis, acne, pustulosis, hyperostosis and osteitis (SAPHO) syndrome. Methods Clinical and imaging data of 12 SAPHO syndrome patients were analyzed retrospectively. The scintigraphic features of SAPHO syndrome were evaluated and compared with those of X-rays, CT and MRI. Results Though anterior chest wall involvement was found in all 12 patients with ^99mTc-MDP imaging, typical "bull's head" sign was detected in only 3 patients (3/12, 25.00%), while incomplete "bull's head" or unilateral "bull's horn" sign were found in the rest 9 patients. Spine involvement occurred in 6 patients, including vertebral body involvement (n=4), multiple adjacent vertebral bodies involvement (n=3) and intervertebral joints involvement (n=2). All bone scintigraphic abnormalities were also showed on other imaging examinations, except for 3 patients with false negative plain X-ray results. Conclusion Typical "bull's head" or incomplete "bull's head", "bull's horn" sign are characteristic scintigraphic features of SAPHO syndrome, being helpful to early diagnosis and evaluation of SAPHO syndrome.