Department of Radiology, Peking University Third Hospital, BeiJing, 100191, China.
Department of Nuclear Medicine, Peking University Third Hospital, BeiJing, 100191, China.
Clin Radiol. 2021 May;76(5):394.e9-394.e14. doi: 10.1016/j.crad.2020.12.005. Epub 2021 Jan 12.
To determine the imaging characteristics of SAPHO (synovitis, acne, pustulosis, hyperostosis, and osteitis) syndrome and seronegative spondyloarthropathies (SpAs) on whole-spine magnetic resonance imaging (WS-MRI) and evaluate the role of WS-MRI in the diagnosis and differentiation of the two diseases.
Twenty-eight patients with SAPHO and 44 with SpAs were included. All patients were symptomatic and clinically diagnosed with SAPHO or SpAs, and all underwent WS-MRI for comparison of imaging characteristics.
The mean age of the SAPHO patients was 48.7 ± 12.7 years, while that of the SpA patients was 34.7 ± 12.3 years (p<0.001). WS-MRI showed that the frequency of cervical, thoracic, and lumbar spine involvement was 53.6% versus 52.3%, 75% versus 88.6%, and 60.7% versus 63.6%, respectively (p=0.70, 0.13, and 0.80). The frequency of sacroiliac joint involvement was 7.1% and 100% (p<0.001). Continuous spinal involvement accounted for 50% versus 43.2%, 60.7% versus 84.1%, and 39.3% versus 40.9% in the cervical, thoracic, and lumbar vertebrae, respectively (p=0.03). WS-MRI showed that bone marrow oedema of spinal anterior corner was observed in 50% versus 75% (p=0.03). Vertebral body and posterior attachment involvement accounted for 85.7% versus 93.2% and 14.3% versus 34.1% (p=0.3, 0.06). The frequency of bone erosion in mobile spine was 75% and 36.4%, respectively (p=0.02). The frequency of intervertebral disc, endplate, anterior thoracic wall, and paraspinal soft-tissue swelling was 42.9% versus 18.2%, 53.6% versus 22.7%, 85.7% versus 42.2%, and 50% versus 11.4% (p=0.02, 0.00).
Factors differentiating the two groups at WS-MRI were bone marrow oedema of the spinal anterior corner, bone erosion, and swelling of the intervertebral disc, endplate, anterior thoracic wall, and paraspinal soft-tissue.
确定 SAPHO（滑膜炎、痤疮、脓疱病、骨肥厚和骨炎）综合征和血清阴性脊柱关节病（SpAs）在全脊柱磁共振成像（WS-MRI）上的影像学特征，并评估 WS-MRI 在这两种疾病的诊断和鉴别中的作用。
纳入 28 例 SAPHO 患者和 44 例 SpA 患者。所有患者均有症状，临床诊断为 SAPHO 或 SpA，均行 WS-MRI 检查，比较影像学特征。
SAPHO 患者的平均年龄为 48.7±12.7 岁，SpA 患者为 34.7±12.3 岁（p<0.001）。WS-MRI 显示颈椎、胸椎和腰椎受累的频率分别为 53.6%对 52.3%、75%对 88.6%和 60.7%对 63.6%（p=0.70、0.13 和 0.80）。骶髂关节受累的频率分别为 7.1%和 100%（p<0.001）。连续脊柱受累在颈椎、胸椎和腰椎的比例分别为 50%对 43.2%、60.7%对 84.1%和 39.3%对 40.9%（p=0.03）。WS-MRI 显示，脊髓前角骨髓水肿分别为 50%对 75%（p=0.03）。椎体和后附着受累的比例分别为 85.7%对 93.2%和 14.3%对 34.1%（p=0.3、0.06）。活动脊柱骨侵蚀的频率分别为 75%和 36.4%（p=0.02）。椎间盘、终板、前胸壁和椎旁软组织肿胀的频率分别为 42.9%对 18.2%、53.6%对 22.7%、85.7%对 42.2%和 50%对 11.4%（p=0.02、0.00）。
WS-MRI 区分两组的因素为脊髓前角骨髓水肿、骨侵蚀和椎间盘、终板、前胸壁和椎旁软组织肿胀。
