18F-FDG PET/CT imaging features and clinical analysis in adult-onset Still’s disease
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
Abstract: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 18F-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) and 3.0 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. 18F-FDG uptake may also be present in glands, joints, and pleura. The correlation analysis showed a positive correlation between bone marrow SUVmax and lactate dehydrogenase, spleen SUVmax and lactate dehydrogenase, spleen SUVmax and hemoglobin concentration(rs=0.599, 0.629, r=0.616, P<0.05). There was no statistically significant correlation between SUVmax in other parts and various indexes of laboratory examination(P>0.05). There was a positive correlation between SUVmax and lymph node size in affected lymph nodes(rs=0.788, P<0.01). Conclusions: 18F-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.
倪 明,汪世存,刘 昕,张依凡,潘 博,展凤麟. 成人Still病的18F-FDG PET/CT显像特征和临床分析[J]. 中国临床医学影像杂志, 2019, 30(5): 350-354.
NI Ming, WANG Shi-cun, LIU Xin, ZHANG Yi-fan, PAN Bo, ZHAN Feng-lin. 18F-FDG PET/CT imaging features and clinical analysis in adult-onset Still’s disease. JOURNAL OF CHINA MEDICAL IMAGING, 2019, 30(5): 350-354.
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