Role of bone scan in the assessment of polymyositis/dermatomyositis
Role of bone scan in the assessment of polymyositis/dermatomyositis
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DOI：
10.1007/s10067-014-2837-2
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发表时间：
2015-04-01
影响因子：
3.4
通讯作者：
Kim, Hyoun-Ah
中科院分区：
文献类型：
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作者：
An, Young-Sil;Suh, Chang-Hee;Kim, Hyoun-Ah
本研究的目的是确定骨扫描结果在韩国多发性肌炎/皮肌炎（PM/DM）患者中的意义。本研究的参与者是26名PM/DM患者，他们符合明确或可能的PM/DM的标准。所有患者均行骨扫描检查。利用摄取比对结果进行了可视化和定量分析。评估六个近端肌群（斜方肌、三角肌、二头肌、髂腰肌、股四头肌、臀中肌和臀大肌）的骨扫描参数与代表疾病活动的临床参数（实验室值和手工肌肉试验）之间的相关性。根据骨骼扫描的视觉分析，14例活动性PM/DM患者中有10例（71.4%）有异常的肌肉摄取。骨扫描的视觉分级评估肌肉炎症的敏感性和特异性分别为74%和90.9%。骨扫描显示，活动性PM/DM患者的最大近端肌肉摄取比明显高于非活动性PM/DM患者（中位数1.97 vs 1.02, p = 0.046）。最大近端摄取比与肌酸激酶（r = 0.394, p = 0.046）、乳酸脱氢酶（r = 0.473, p = 0.015）、醛缩酶（r = 0.428, p = 0.029）、红细胞沉降率（r = 0.412, p = 0.036）、c反应蛋白（r = 0.454, p = 0.002）、手肌试验结果（r = -0.399, p = 0.044）显著相关。平均近端肌肉摄取比与LDH （r = 0.438, p = 0.025）和醛缩酶（r = 0.572, p = 0.002）显著相关。目视评估的近端肌肉摄取等级和最大近端肌肉摄取比率（由骨扫描确定）与已知PM/DM疾病活动标记物的水平显著相关。本研究结果提示骨扫描是评估PM/DM患者的一种有用的成像技术。
The aim of this study was to determine the significance of bone scan findings in Korean polymyositis/dermatomyositis (PM/DM) patients. The participants in this study were 26 PM/DM patients who fulfilled the proposed criteria for definite or probable PM/DM. All patients had been examined by bone scan. The results were analyzed visually and quantitatively using the uptake ratios. Correlations between the bone scan parameters of six proximal muscle groups (trapezius, deltoid, biceps, iliopsoas, quadriceps, and gluteus medius and maximus) and clinical parameters (laboratory values and manual muscle test) representing disease activities were assessed. Based on visual analyses of their bone scans, 10 of 14 (71.4 %) patients with active PM/DM had abnormal muscle uptake. Visual grading of the bone scans had a sensitivity and specificity of 74 and 90.9 %, respectively, for the assessment of muscle inflammation. Maximal proximal muscle uptake ratios, as determined on the bone scans, were significantly higher in patients with active PM/DM than in those with inactive disease (median 1.97 vs. 1.02, p = 0.046). Maximal proximal uptake ratios correlated significantly with creatine kinase (r = 0.394, p = 0.046), lactate dehydrogenase (LDH, r = 0.473, p = 0.015), aldolase (r = 0.428, p = 0.029), erythrocyte sedimentation rate (r = 0.412, p = 0.036), C-reactive protein (r = 0.454, p = 0.002), and manual muscle test results (r = -0.399, p = 0.044). Mean proximal muscle uptake ratios correlated significantly with LDH (r = 0.438, p = 0.025) and aldolase (r = 0.572, p = 0.002). Visually assessed proximal muscle uptake grades and maximal proximal muscle uptake ratios as determined by bone scan correlated significantly with the levels of known PM/DM disease activity markers. The findings of this study suggest that bone scan is a useful imaging technique for the evaluation of PM/DM patients.