成人Still病的18F-FDG PET/CT影像学特征及其与疾病活动度的相关性OA

Objective To investigate the imaging characteristics of 18F-FDG PET/CT in patients with adult-onset Still's disease(AOSD)and evaluate their association with disease activity.Methods We retrospectively analyzed 18F-FDG PET/CT imaging features,clinical manifestations,and laboratory results of 23 patients with AOSD who were treated at Northern Theater General Hospital from May 2016 to December 2024.We calculated the maximum standardized uptake value ratios of the spleen,bone marrow,and lymph nodes to the liver(SLRmax,BLRmax,and LyLRmax,respectively).Spearman's rank correlation analysis was performed to evaluate the relationships between these metabolic parameters and laboratory indicators as well as clinical activity scores.Multiple comparisons were adjusted using false discovery rate(FDR)correction,with a corrected q-value<0.05 considered significant.Inter-rater agreement was evaluated using the intraclass correlation coefficient).Results All 23 patients demonstrated abnormal FDG uptake,primarily involving lymph nodes(100%),most commonly in cervical,axillary,supraclavicular,and inguinal regions.Increased splenic uptake was observed in all patients(100%),while bone marrow involvement was identified in 21 patients(91.3%).Additional uptake sites included the liver(n=1,4.3%),shoulder joints(n=4,17.4%),submandibular glands(n=4,17.4%),tonsils(n=3,13.0%),and cutaneous nodules(n=2,8.7%).The mean liver SUVmax was 3.6±0.5,while the spleen and bone marrow showed SUVmax values of 4.1±0.7 and 4.4±0.9,respectively.The median lymph node SUVmax was 4.8(4.1,12.5),with corresponding SLRmax,BLRmax,and LyLRmax values of 1.14±0.09,1.25±0.31,and 1.42(1.09,3.42).Clinical activity system scores ranged from 5-10[7(6-8)].SLRmax and LyLRmax showed positive correlations with CRP(ρ=0.471 and 0.560,respectively,uncorrected P<0.05).BLRmax and LyLRmax were also positively correlated with the clinical activity system scores(ρ=0.432 and 0.416;uncorrected P<0.05).None of these correlations remained statistically significant after FDR correction.Additionally,lymph node SUVmax was positively correlated with lymph node length(ρ=0.518,P<0.05).Conclusion 18F-FDG PET/CT can comprehensively depict the extent of systemic involvement in AOSD.Although the correlations between metabolic parameters and clinical indicators did not reach statistical significance after FDR correction,the observed trends still suggest a potential association between them.