^(18)F-FDG PET/CT显像在特发性炎性肌病中的多重价值

Multiple Value of^(18)F-FDG PET/CT Imaging in Idiopathic Inflammatory Myopathy

目的:探讨^(18)F-FDG PET/CT显像在特发性炎性肌病(IIM)中的多重价值。方法:通过回顾性分析2014年8月至2022年4月在我院行PET/CT检查的特发性炎症性肌病患者21例,搜集患者的临床资料、肌酶等相关实验室指标及PET/CT影像资料。同时选取年龄及性别相匹配的PET/CT健康体检者21例(排除风湿性疾病及恶性肿瘤病史),并进行分析。结果:IIM患者肌肉SUVmax为(2.51±0.87)g/mL,对照组肌肉SUVmax为(1.24±0.26)g/mL。IIM患者肌肉的FDG摄取量显著高于对照组,差异具有统计学意义(t=23.6,P<0.005)。ROC曲线结果分析显示,^(18)F-FDG PET/CT显像诊断IIM的最佳诊断截点为SUVmax=1.705g/mL,此时曲线下面积(Area Under Curve,AUC)为0.99,诊断灵敏度为90.5%,特异性为98.7%。21例IIM患者中,经PET/CT检查发现并最终确诊为恶性肿瘤的患者5例,包括鼻咽癌、食管癌、乳腺癌、乙状结肠癌及肺弥漫性大B细胞淋巴瘤。恶性肿瘤病灶的SUVmax为(4.68±1.77)g/mL。合并间质性肺病ILD患者14例,肺部病灶SUVmax为(2.44±1.36)g/mL。Pearson相关性分析显示,IIM患者四肢FDG摄取与血清肌酸激酶(CK)(r=0.742,P<0.05)、肌酸激酶同工酶(CK-MB)(r=0.863,P<0.05)及乳酸脱氢酶(LDH)(r=0.897,P<0.05)水平升高均呈正相关性。结论:对于IIM患者,^(18)F-FDG PET/CT在评估肌病状态、诊断恶性肿瘤及间质性肺疾病等方面具有多重价值。因此,PET/CT可作为一种有效的影像诊断手段,通过一次成像进行多器官探查,用于IIM及相关并发症的诊断及病情评估。

Objective:To explore the multiple value of^(18)F-FDG PET/CT imaging in idiopathic inflammatory myopathy(IIM).Methods:21 patients with idiopathic inflammatory myopathy who underwent PET/CT examination in the Affiliated Hospital of Jiangsu University from August 2014 to April 2022 were retrospectively analyzed.The clinical data,muscle enzymes and other related laboratory indicators and PET/CT image data of the patients were collected.At the same time,21 cases of PET/CT physical examination matched with age and sex(excluding the history of rheumatic diseases and malignant tumors)were selected and analyzed.Results:the muscle SUVmax of IIM patients was(2.51±0.87)g/mL,and that of the control group was(1.24±0.26)g/mL.The FDG intake of IIM patients was significantly higher than that of the control group(t=23.6,P<0.005).The analysis of ROC curve results shows that the best diagnostic cut-off point for^(18)F-FDG PET/CT imaging in the diagnosis of IM is SUVmax=1.705g/mL.At this time,the area under curve(AUC)is 0.99,the diagnostic sensitivity is 90.5%,and the specificity is 98.7%.Among the 21 patients with IIM,5 patients were finally diagnosed as malignant tumors after PET/CT examination,including nasopharyngeal carcinoma,esophageal cancer,breast cancer,sigmoid colon cancer and pulmonary diffuse large B-cell lymphoma.SUVmax of malignant tumor focus was(4.68±1.77)g/mL.In 14 patients with interstitial lung disease(ILD),the SUVmax of lung lesions was(2.44±1.36)g/mL.Pearson correlation analysis showed that FDG uptake in limbs of IIM patients was positively correlated with the increase of serum creatine kinase(CK)(r=0.742,P<0.05),creatine kinase isoenzyme(CK-MB)(r=0.863,P<0.05)and lactate dehydrogenase(LDH)(r=0.897,P<0.05).Conclusion:for IM patients,^(18)F-FDG PET/CT has muliple values in evaluating myopathy status,diagnosing malignant tumors and interstitial lung diseases.Therefore,^(18)F-FDG PET/CT can be used as an effective imaging diagnostic method to evaluate multiple organs through one imaging for the diagnosis and condition evaluation of IIM and related complications.