摘要目的：总结滑膜炎、痤疮、脓疱病、骨肥厚、骨炎（ SAPHO）综合征的99 Tcm?MDP全身骨显像及SPECT／CT影像特点，探讨SPECT／CT在SAPHO综合征诊断中的作用。方法回顾性分析2009年至2014年间6例SAPHO综合征患者（男1例，女5例，平均年龄63岁；病程1个月～7年）的骨显像及SPECT／CT断层显像资料，其中3例患者骨显像后进行了胸锁关节活组织检查。总结SAPHO综合征的全身骨显像及SPECT／CT的影像特点。结果6例患者胸锁关节区骨代谢均升高，其中2例为对称性。 SPECT／CT发现6例患者共8个受累胸锁关节，其中6个以关节侵蚀为主要表现；3例伴胸锁关节周围软组织肿胀；4例伴胸锁关节外病变16处，依次为胸骨及胸骨柄与胸骨体连接处、骶髂关节、椎体、耻骨、胸肋关节、肋骨、颅骨及足。胸骨外病变以骨关节侵蚀破坏为主要表现。结论SPECT／CT可发现SAPHO典型的胸锁关节侵蚀及更多的胸锁关节外病变，能够提高对SAPHO综合征的诊断准确性。

abstractsObjective To investigate the imaging characteristics of 99 Tcm?MDP bone SPECT/CT imaging in patients with synovitis, acne, pustulosis, hyperostosis, osteitis ( SAPHO) syndrome, and to e?valuate its diagnostic value. Methods 99 Tcm?MDP whole?body bone scan and SPECT/CT imaging were performed in 6 patients ( 1 male, 5 females, average age 63 years) with SAPHO syndrome ( duration:1 month to 7 years) from 2009 to 2014. Three patients underwent biopsy in sternoclavicular joint. Characteris?tics of 99 Tcm?MDP bone scan and SPECT/CT imaging were investigated. Results 99 Tcm?MDP whole?body bone scan detected high radioactivity in sternoclavicular joints of all patients, 2 cases were affected bilateral?ly and presented typical"bull horn" sign, the other 4 cases were unilaterally. A total of 8 affected sternocla?vicular joints were found, and 6 of which showed articular erosion. Three patients had soft tissue swelling. Four patients had 16 additional lesions ( sternum, sacroiliac joint, vertebral, pubis, sternocostal joint, rib, skull and foot) besides the diseased sternoclavicular joints, and erosion was the main imaging feature of these non?sternoclavicular lesions. SPECT/CT imaging also found sacroiliac joint sclerosis and spine ankylo?sis without abnormal increased uptake. Conclusion SAPHO syndrome has typical imaging characteristics in the sternoclavicular region, and SPECT/CT imaging can reveal its underlying changes and detect addi?tional lesions besides the sternoclavicular region, thus can improve the diagnostic accuracy.