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F-氟代脱氧葡萄糖正电子发射断层扫描/计算机断层扫描在皮肌炎患者间质性肺病和肌炎中的临床价值。

Clinical value of F-fluorodeoxyglucose positron emission tomography/computed tomography for interstitial lung disease and myositis in patients with dermatomyositis.

机构信息

Department of Dermatology, Gunma University Graduate School of Medicine, Maebashi, Japan.

Department of Allergy Respiratory Medicine, Gunma University Graduate School of Medicine, Maebashi, Japan.

出版信息

J Dermatol. 2019 Mar;46(3):213-218. doi: 10.1111/1346-8138.14758. Epub 2019 Jan 4.

Abstract

F-Fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) is usually used to screen malignancy in patients with dermatomyositis (DM). Additionally, it is well known that FDG-PET/CT provides valuable information for evaluating the activity of several inflammatory diseases, such as sarcoidosis, atherosclerosis, inflammatory bowel disease and rheumatoid arthritis. Therefore, the objective of this study was to evaluate the clinical usefulness of FDG-PET/CT for the detection of inflammatory lesions and disease activity of both myopathy and interstitial lung disease (ILD) in DM patients. We measured the maximum standardized uptake value (SUVmax) in the muscles and lungs in 22 DM patients, and compared with magnetic resonance imaging (MRI) and high-resolution computed tomography (HRCT) findings in the same muscle and lung regions as well as with clinical findings. We found that the location of increased FDG uptake was nearly consistent with the region of ILD and myositis detected by HRCT or MRI, respectively. There was a significant positive correlation between lung HRCT score and SUVmax in each lung. Serum Krebs von den Lungen-6 levels also revealed significant positive correlation with total SUVmax of right and left lungs. Regarding FDG-PET/CT and myopathy, total SUVmax in the muscles was significantly correlated with serum cytokeratin levels. Our results suggest that FDG uptake (SUVmax) might be useful for not only the detection of malignant tumors, but also the evaluation of the location and activity of ILD and myositis in DM patients.

摘要

氟代脱氧葡萄糖(FDG)正电子发射断层扫描(PET)/计算机断层扫描(CT)通常用于筛查皮肌炎(DM)患者的恶性肿瘤。此外,众所周知,FDG-PET/CT 为评估几种炎症性疾病的活动提供了有价值的信息,如结节病、动脉粥样硬化、炎症性肠病和类风湿关节炎。因此,本研究的目的是评估 FDG-PET/CT 在检测 DM 患者肌病和间质性肺病(ILD)的炎症病变和疾病活动中的临床应用价值。我们测量了 22 例 DM 患者肌肉和肺部的最大标准化摄取值(SUVmax),并将其与同一肌肉和肺部区域的磁共振成像(MRI)和高分辨率计算机断层扫描(HRCT)结果以及临床发现进行了比较。我们发现,FDG 摄取增加的部位与 HRCT 或 MRI 分别检测到的ILD 和肌炎区域几乎一致。肺部 HRCT 评分与每个肺部的 SUVmax 之间存在显著的正相关。血清 Krebs von den Lungen-6 水平也与右肺和左肺的总 SUVmax 呈显著正相关。关于 FDG-PET/CT 和肌病,肌肉的总 SUVmax 与血清细胞角蛋白水平显著相关。我们的结果表明,FDG 摄取(SUVmax)不仅可用于检测恶性肿瘤,还可用于评估 DM 患者的ILD 和肌炎的位置和活动。

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