基于22例SAPHO综合征患者全脊柱病变的MRI表现

MRI findings of whole spinal in 22 patients with SAPHO syndrome

目的评估SAPHO综合征全脊柱病变的MRI表现,探索其影像学规律。材料与方法分析22例SAPHO综合征全脊柱病变MRI图像,对活动性病变和结构性病变及椎旁、椎间隙病变的特征进行评估、统计与分析。结果 SAPHO综合征脊柱受累病变主要在胸段(占脊柱病变的45.4%)(P<0.05),其中活动性病变骨髓水肿(bone marrow edema,BME)和结构性病变脂质沉积最为常见,且均以胸段前侧椎角为主,跳跃分布和对吻分布分别为:BME 53.3%、46.7%,脂质沉积41.3%、58.7%。其他病变包括骨桥(3.9%)、骨质破坏(19.2%)、骨质硬化(3.0%)、椎间隙狭窄(4.3%)、压缩性骨折(3.5%)和椎旁软组织水肿(4.6%)。结论 SAPHO综合征全脊柱病变以胸椎前侧椎角的BME和脂质沉积为主,呈跳跃和对吻分布,具有一定的特征性。

Objective:To evaluate MRI manifestations of the whole spinal lesions of synovitis,acne,palmoplantar pustulosis,hyperostosis and osteitis(SAPHO)syndrome and investigate its regularity.Materials and Methods:The distribution,involvement patterns,and characteristics of both active inflammatory and chronic structural lesions of the whole spine 3.0 T MRI images of 22 SAPHO syndrome patients were analyzed.Auto-tracking-bedscanning technic was applied to scan the cervical,thoracic,and lumbar part and the image was stitched by whole spine imaging software.Results:SAPHO syndrome involvement spinal lesions were mainly located in the thoracic segments(45.4%of spinal lesions)(P<0.05).Bone marrow edema(BME)was the most common active lesion,and lipid deposition was the most common structural lesion,which were mainly distributed at the anterior corners of thoracic vertebra.The jump distribution and parallel distribution were 53.3%and 46.7%of BME,41.3%and 58.7%of lipid deposition,respectively.Other lesions included bone bridge(3.9%),bone erosion(19.2%),osteosclerosis(3.0%),narrowing of intervertebral space(4.3%),compression fractures(3.5%),involvement of the paravertebral soft tissue(4.6%).Conclusions:The whole spinal lesions of SAPHO syndrome is characterized by BME and lipid deposition at the anterior corners of thoracic vertebra,which are distributed in jump and parallel manners.These characteristics may be diagnostic clue for SAPHO syndrome.