结节病累及中轴骨预后良好：48例患者的纵向研究

IF 4.6 2区医学 Q1 RHEUMATOLOGY

Seminars in arthritis and rheumatism Pub Date : 2025-02-05 DOI:10.1016/j.semarthrit.2025.152654

S Challal , E Riviere , B Lanseur , F Jeny , H Nunes , M Soussan , MC Boissier , L Semerano , N Saidenberg-Kermanac'h

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引用次数: 0

摘要

目的在正电子发射断层扫描（PET）上观察到约25%的结节病患者中轴骨受累。许多这些病变是无症状的，它们的长期预后也不明确。本研究旨在评估组织学证实的结节病中轴骨病变的预后。方法对48例诊断为轴型骨结节病的患者（MRI 135例，PET 132例）进行初始和随访MRI和PET检查，平均随访时间分别为33个月和44个月。评估影像学结果与患者变量之间的基线和纵向关联。结果smri主要显示结节性骨髓替代病变，PET显示多灶性骨受累，80.8%的病例CT未发现相应的骨病变。与基线成像相比，连续MRI和PET显示骨病变随着时间的推移显著减少或消退(MRI: p <；0.01;PET: p <；0.001)。PET（68.3%）比MRI（19.5%）更常见。随访期间，骨痛明显改善（p = 0.01），这与PET和MRI检查结果的有利变化相关（p = 0.02和p = 0.04）。7例出现骨复发。未见硬膜外炎及软组织浸润。这项为期3年的纵向评估，结合临床、放射学和生化数据，显示结节病轴向骨病变预后良好。MRI和PET检查均有显著改善。骨痛的改善与有利的影像学改变有关。

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Axial bone involvement in sarcoidosis has a good prognosis: Longitudinal study of a cohort of 48 patients

Objectives

Axial bone involvement in sarcoidosis is observed in approximately 25 % of patients on positron emission tomography (PET). Many of these lesions are asymptomatic, and their long-term outcomes are not well defined. This study aims to evaluate the prognosis of axial bone lesions in histologically confirmed sarcoidosis.

Methods

We assessed initial and follow-up MRI and PET from 48 patients diagnosed with axial bone sarcoidosis (135 MRI and 132 PET), with a mean follow-up duration of 33 and 44 months, respectively. Baseline and longitudinal associations between imaging results and patient variables were evaluated.

Results

MRI revealed predominantly nodular marrow replacement lesions, while PET identified multifocal bone involvement, with no corresponding bone lesions detected on CT in 80.8 % of cases. Compared to baseline imaging, serial MRI and PET showed significant reduction or resolution of bone lesions over time (MRI: p < 0.01; PET: p < 0.001). This was more frequently observed on PET (68.3 % of patients) than on MRI (19.5). During follow-up, bone pain improved significantly (p = 0.01), which was associated with favorable changes in both PET and MRI findings (p = 0.02 and p = 0.04, respectively). Seven patients had bone relapse. No epiduritis or soft-tissue infiltration was observed.

Discussion

This longitudinal evaluation over a 3-year period, combining clinical, radiological, and biochemical data, shows that sarcoidosis axial bone lesions have a favorable prognosis. Significant improvement was observed on both MRI and PET. The improvement in bone pain was associated with favorable imaging changes.

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来源期刊

Seminars in arthritis and rheumatism 医学-风湿病学

CiteScore

9.20

自引率

4.00%

发文量

176

审稿时长

46 days

期刊介绍： Seminars in Arthritis and Rheumatism provides access to the highest-quality clinical, therapeutic and translational research about arthritis, rheumatology and musculoskeletal disorders that affect the joints and connective tissue. Each bimonthly issue includes articles giving you the latest diagnostic criteria, consensus statements, systematic reviews and meta-analyses as well as clinical and translational research studies. Read this journal for the latest groundbreaking research and to gain insights from scientists and clinicians on the management and treatment of musculoskeletal and autoimmune rheumatologic diseases. The journal is of interest to rheumatologists, orthopedic surgeons, internal medicine physicians, immunologists and specialists in bone and mineral metabolism.