目的：探讨18F-FDG PET/CT在成人Still病（Adult-onset still disease，AOSD）中的表现及其评估疾病活动度的作用。方法：选取确诊为AOSD并进行18F-FDG PET/CT检查的患者46例，收集其临床资料和PET/CT特点，分析AOSD患者的骨髓、脾脏、淋巴结标准化摄取值（Standardized uptake values，SUV）强度与实验室指标、系统评分之间的相关性。结果：AOSD的18F-FDG摄取主要发生于骨髓（100%，SUV强度：2.00±0.66）、脾（96%，SUV强度：1.70±0.54）及淋巴结（98%，SUV强度：2.67±1.38），此外18F-FDG摄取还可发生于心包、胸膜、咽部、颌下腺、腮腺、甲状腺、皮肤、关节、食管、贲门部位。骨髓SUV强度与疾病系统评分、血沉、C-反应蛋白、白细胞计数和中性粒百分数显著相关（r=0.445、0.376、0.323、0.439、0.524，P<0.05）。脾脏SUV强度与疾病系统评分、乳酸脱氢酶显著相关（r=0.424、0.347，P<0.05）。淋巴结SUV强度与疾病系统评分显著相关（r=0.356，P<0.05）。结论：AOSD在18F-FDG PET/CT上主要表现为骨髓、脾脏及淋巴结的FDG高摄取，18F-FDG PET/CT有助于监测疾病活动性。
Abstract
Objective: To investigate the expression of 18F-FDG PET/CT in patients with adult-onset Still’s disease (AOSD) and its role in disease activity. Methods: 46 patients who was diagnosed as AOSD were selected and underwent 18F-FDG PET/CT. The clinical manifestations, laboratory examination and characteristics of PET/CT were collected. Then the correlation between SUV intensity of liver, spleen, bone marrow, lymph node and laboratory indexes, system scores were analyzed. Results: 18F-FDG accumulation occurred mainly in bone marrow(100%, SUV intensity: 2.00±0.66), Spleen(96%, SUV intensity:1.70±0.54) and lymph nodes(98%, SUV intensity: 2.67±1.38). In addition, 18F-FDG uptake can also occur in the pericardial pleural, parotid gland, thyroid, skin, joint esophagus and cardia. SUV intensity of bone marrow was significantly correlated with systemic score, ESR, C-reactive protein, WBC and NEU%(r=0.445, 0.376, 0.323, 0.439, 0.524, P<0.05). SUV intensity of spleen was significantly correlated with system score and LDH(r=0.424, 0.347, P<0.05). SUV intensity of lymph node was significantly correlated with disease system score(r=0.356, P<0.05). Conclusion: 18F-FDG accumulation occurred mainly in bone marrow, spleen and lymph nodes. 18F-FDG PET/CT is helpful for the differential diagnosis and monitoring of disease activity.
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
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基金
辽宁省科学计划项目（编号2015020546）。
