Analysis Of ¹⁸F-FDG PET/CT Imaging Of Patients With Painful Schmorl's Nodes

Objective:The aim of the study was to ananlyze the 18F-FDG PET/CT manifestations of painful Schmorl's nodes,then to increase the accuracy of diagnosis and differentiation, decrease the use of invasive diagnostic procedures and unnecessary therapeutic procedures,reduce the diagnodtic and therapeutic risk to patients.Methods:10 patients with painful Schmorl's nodes,18 patients with vertebrae metastases underwent 18F-FDG PET/CT.The images were analyzed on the basis of lesion location,form on CT images,distribution pattern of F-FDG uptake,relation between the form on CT images and the pattern of F-FDG uptake.Mesure maximum uptake volumes of lesions with ROI(region of interest) and compare the maximum uptake volumes of Schmorl's nodes and vertebrae metastases with t test.Results:In 10 painful Schmorl's nodes,there were 8 cases with solitary lesion and 2 with multiple lesions. All Schmorl's node lesions located on the vertebrae superior end plate or inferior end plate.The lesions located on thoracic vertebrae all locate in the medium of the end plate.The lesions located on lumbar vertebrae often locate in the inferior end plate,4 in the anterior portion,3 in the medium portion and 3 in the posterior portion.Vertebrae metastases lesions often locate in thoracic vertebrae,all lesions are within the bone marrow. All Schmorl's node lesions have the similar manifestations on CT images:radiolucent lesions of the vertebral bodies limited by disintegrtated or indistinct sclerosis,connected with the intervertebral disk and 18F-FDG hot uptake in radiolucent lesions and (/or) in sclerosis,All the inter vertebrae space adjacent to the Schmorl's node is narrow.On the CT images of vertebrae metastases,we can not see the similar manifestations with Schmorl's nodes.The difference of SUVmax between painful Schmorl's nodes and vertebrae metastases has no statistic significance.Conclusions:Differentiation between painful Schmorl's and vertebrae metastases is necessay. Painful Schmorl's nodes have characteristic manifestations,if find the characteristic manifestations,we can diagnose Painful Schmorl's nodes.In addition,follow up can help the differentiation between painful Schmorl's nodes and vertebrae metastases.