CT与核素骨显像诊断SAPHO综合征的对比分析

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摘要目的：探讨滑膜炎、痤疮、脓疱病、骨肥厚、骨炎综合征（即SAPHO综合征）的CT与核素骨显像影像表现。方法：回顾性对比分析29例SAPHO综合征患者的CT、核素骨显像影像特征。结果：CT检查前上胸壁受累24例，表现为骨及肋软骨硬化、肥厚，关节破坏、强直；骶髂关节受累10例，表现为骶髂关节周围骨质增生硬化，关节间隙变窄，骨质破坏；12例患者脊柱CT检查8例受累，示终板侵蚀、硬化，椎间隙变窄，部分椎体楔形变。99mTc-MDP骨显像表现为受累骨关节处异常放射性浓聚，其中前胸壁受累最常见，约占93.1%（27/29），在胸肋锁骨区表现为“牛头”状放射性核素浓聚，是特征性骨显像表现，骶髂关节受累11例，脊柱受累8例，下颌骨受累1例，长骨受累1例。结论：胸前壁多骨受累是SAPHO综合征主要影像特点，CT扫描准确显示骨质硬化、肥厚、破坏及关节强直。99mTc-MDP骨显像有助于疾病的早期诊断及发现隐匿性病灶，当前胸壁受累出现典型影像表现时，应考虑SAPHO综合征。

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	张强
	次旦旺久
	孙洪赞
	郭启勇

关键词 ：获得性骨肥大综合征, 体层摄影术, 螺旋计算机, 体层摄影术, 发射型计算机, 单光子

Abstract：Objective: To explore the CT and bone scintigraphy features of patients with synovitis, acne, pustulosis, hyperostosis and osteitis(SAPHO) syndrome. Methods: CT and 99mTc-MDP features of 29 cases with SAPHO syndrome were retrospectively analyzed. Results: Twenty-four patients had anterior chest wall involved on CT, which showed bone sclerosis, hyperostosis, costal cartilage sclerotic hyperostosis, joint destruction and ankylosis; ten patients also had sacroiliac joint involvement, which showed sclerosis and hyperostosis on the iliac side of the sacroiliac joint, destruction of the articular surface and narrowing of joint space; eight patients had spinal involvement, which showed end plate erosion, sclerosis, paravertebral ossification, narrowed disc space, wedged body. Bone scintigraphy showed an increased uptake in ostearticular involvement. The anterior chest wall involvement was the commonest; it was presented in 27 patients(93.1%). Symmetric uptake in the sternoclavicular region with a typical “bull-horn” appearance was shown in bone scintigraphy by characteristic of the SAPHO syndrome. The uptake was also localized in: sacroiliac joints in 11, spine in 8, mandible, thighbone-one in each patient. Conclusion: Multi-bones of anterior chest wall involved was the common imaging characteristics, CT can accurately demonstrate bone sclerosis, hyperostosis, destruction and joint ankylosis. Bone scintigraphy can be very useful for an early diagnosis and localize the insidious lesion. SAPHO syndrome should be considered as they had the anterior chest wall involved and typical radiological features.

Key words： Acquired hyperostosis syndrome Tomography, spiral computed Tomography, emission-computed, single-photon

收稿日期: 2015-10-28

PACS:	Ｒ681
	Ｒ814.42
	Ｒ817.4

通讯作者: 郭启勇，中国医科大学附属盛京医院放射科，110004。E-mail：guoqy@sj-hospital.org

作者简介: 张强（1975-），男，辽宁兴城人，在读硕士研究生。E-mail：CMU_zhangqiang@163.com

引用本文:

张强，次旦旺久，孙洪赞，郭启勇. CT与核素骨显像诊断SAPHO综合征的对比分析[J]. 中国临床医学影像杂志, 2016, 27(8): 589-593.
ZHANG Qiang, CIDAN Wang-jiu, SUN Hong-zan, GUO Qi-yong. Comparison analysis of CT and bone scintigraphy in diagnosis of SAPHO syndrome. JOURNAL OF CHINA MEDICAL IMAGING, 2016, 27(8): 589-593.

链接本文:

http://www.jccmi.com.cn/CN/ 或 http://www.jccmi.com.cn/CN/Y2016/V27/I8/589

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