氟代脱氧葡萄糖正电子发射断层扫描/计算机断层扫描在多发性肌炎/皮肌炎患者中的应用：与血清肌酶的相关性
F-FDG PET/CT in patients with polymyositis/dermatomyositis: correlation with serum muscle enzymes.
作者信息
Arai-Okuda Hanae, Norikane Takashi, Yamamoto Yuka, Mitamura Katsuya, Fujimoto Kengo, Takami Yasukage, Wakiya Risa, Nakashima Shusaku, Dobashi Hiroaki, Nishiyama Yoshihiro
机构信息
Department of Radiology, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa, 761-0793, Japan.
Division of Hematology, Rheumatology and Respiratory Medicine, Department of Internal Medicine, Faculty of Medicine, Kagawa University, Kagawa, Japan.
出版信息
Eur J Hybrid Imaging. 2020 Aug 12;4(1):14. doi: 10.1186/s41824-020-00084-w.
BACKGROUND
Muscle enzymes are the major noninvasive diagnostic parameters useful in polymyositis/dermatomyositis (PM/DM). Few studies have yet correlated findings on F-FDG PET with disease activity in patients with PM/DM.
PURPOSE
We evaluated F-FDG muscle uptake in patients with PM/DM compared with non-muscular diseases and correlated the results with serum muscle enzymes.
METHODS
A total of 28 patients with untreated PM/DM and 28 control patients with non-muscular diseases were examined with F-FDG PET/CT. F-FDG uptake was evaluated in 9 proximal skeletal muscle regions bilaterally. The uptake was scored as follows: 0 = less than that of the mediastinal blood vessels, 1 = greater than or equal to that of the mediastinal blood vessels, and 2 = greater than or equal to that of the liver. A score 1 or 2 was considered positive. The mean and maximum standardized uptake values (SUV) were calculated in each muscle and were averaged for all muscle regions. PET findings were correlated with serum muscle enzymes.
RESULTS
F-FDG uptake was observed in 82% of patients with PM/DM and 7% of control patients. The number of positive regions, total score, mean SUVmean, and mean SUVmax in patients with PM/DM were significantly higher than those in the control patients (all P < 0.001). The total score of 2 was the best cut-off value that could discriminate patients with PM/DM from control patients. The total score, mean SUVmean, and mean SUVmax showed significant correlations with creatine kinase (P = 0.047, 0.002, 0.010, respectively) and aldolase (P = 0.036, 0.005, 0.038, respectively).
CONCLUSION
F-FDG PET/CT using visual and SUV methods demonstrated its usefulness by discriminating PM/DM from non-muscular diseases and correlating with serum muscle enzymes in patients with PM/DM.
背景
肌肉酶是用于诊断多发性肌炎/皮肌炎（PM/DM）的主要非侵入性诊断参数。很少有研究将F-FDG PET的检查结果与PM/DM患者的疾病活动度相关联。
目的
我们评估了PM/DM患者与非肌肉疾病患者的F-FDG肌肉摄取情况，并将结果与血清肌肉酶进行关联。
方法
共有28例未经治疗的PM/DM患者和28例非肌肉疾病对照患者接受了F-FDG PET/CT检查。双侧9个近端骨骼肌区域的F-FDG摄取情况进行了评估。摄取情况评分如下：0 = 低于纵隔血管；1 = 大于或等于纵隔血管；2 = 大于或等于肝脏。评分1或2被视为阳性。计算每块肌肉的平均和最大标准化摄取值（SUV），并对所有肌肉区域求平均值。PET检查结果与血清肌肉酶进行关联。
结果
82%的PM/DM患者和7%的对照患者观察到F-FDG摄取。PM/DM患者的阳性区域数量、总分、平均SUVmean和平均SUVmax显著高于对照患者（所有P < 0.001）。总分2是区分PM/DM患者与对照患者的最佳临界值。总分、平均SUVmean和平均SUVmax与肌酸激酶（分别为P = 0.047、0.002、0.010）和醛缩酶（分别为P = 0.036、0.005、0.038）显著相关。
结论
使用视觉和SUV方法的F-FDG PET/CT通过区分PM/DM与非肌肉疾病以及与PM/DM患者的血清肌肉酶相关联，证明了其有用性。
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