中华核医学杂志
中華覈醫學雜誌
중화핵의학잡지
CHINESE JOURNAL OF NUCLEAR MEDICINE
2010年
4期
237-241
,共5页
李原%王茜%岳明纲%李河北%洪莲%聂玉新%王玉%张彩群%梁铁军%赵亚妹
李原%王茜%嶽明綱%李河北%洪蓮%聶玉新%王玉%張綵群%樑鐵軍%趙亞妹
리원%왕천%악명강%리하북%홍련%섭옥신%왕옥%장채군%량철군%조아매
骨肿瘤%骶骨%放射性核素显像%MDP
骨腫瘤%骶骨%放射性覈素顯像%MDP
골종류%저골%방사성핵소현상%MDP
Bone neoplasms%Sacrum%Radionuclide imaging%MDP
目的 评价术前骨显像在骶骨肿瘤诊断中的临床价值.方法 103例骶骨肿瘤患者术前进行了99Tcm-亚甲基二膦酸盐(MDP)全身骨显像,其中39例加做了局部断层显像.全身显像用于观察有无多骨病变及骶骨肿瘤对显像剂的摄取;断层显像用于进一步观察骶骨肿瘤的核素摄取特征.结果 该组恶性肿瘤为65例,良性病变38例.骨显像在17.5%(18/103)的患者中检出了多发病灶,51.7%(12/21)的转移性骶骨瘤患者在骨显像上仅表现骶骨单发病变.骶骨肿瘤表现为放射性减低型者在平面显像中占46.6%(48/103),在断层显像中占84.6%(33/39).放射性浓聚型或伴局部浓聚的放射性减低型骶骨肿瘤多为恶性病变;而单纯的放射性减低型骶骨肿瘤在无多骨病变发生的情况下多为良性病变;呈现"炸面圈"征的骶骨肿瘤则多为骨巨细胞瘤.结论 骶骨肿瘤术前骨显像有助于全身多发病变的筛查,但对于单发的转移性肿瘤其诊断价值有限;观察肿瘤对显像剂的摄取特征,可为其鉴别诊断提供帮助.
目的 評價術前骨顯像在骶骨腫瘤診斷中的臨床價值.方法 103例骶骨腫瘤患者術前進行瞭99Tcm-亞甲基二膦痠鹽(MDP)全身骨顯像,其中39例加做瞭跼部斷層顯像.全身顯像用于觀察有無多骨病變及骶骨腫瘤對顯像劑的攝取;斷層顯像用于進一步觀察骶骨腫瘤的覈素攝取特徵.結果 該組噁性腫瘤為65例,良性病變38例.骨顯像在17.5%(18/103)的患者中檢齣瞭多髮病竈,51.7%(12/21)的轉移性骶骨瘤患者在骨顯像上僅錶現骶骨單髮病變.骶骨腫瘤錶現為放射性減低型者在平麵顯像中佔46.6%(48/103),在斷層顯像中佔84.6%(33/39).放射性濃聚型或伴跼部濃聚的放射性減低型骶骨腫瘤多為噁性病變;而單純的放射性減低型骶骨腫瘤在無多骨病變髮生的情況下多為良性病變;呈現"炸麵圈"徵的骶骨腫瘤則多為骨巨細胞瘤.結論 骶骨腫瘤術前骨顯像有助于全身多髮病變的篩查,但對于單髮的轉移性腫瘤其診斷價值有限;觀察腫瘤對顯像劑的攝取特徵,可為其鑒彆診斷提供幫助.
목적 평개술전골현상재저골종류진단중적림상개치.방법 103례저골종류환자술전진행료99Tcm-아갑기이련산염(MDP)전신골현상,기중39례가주료국부단층현상.전신현상용우관찰유무다골병변급저골종류대현상제적섭취;단층현상용우진일보관찰저골종류적핵소섭취특정.결과 해조악성종류위65례,량성병변38례.골현상재17.5%(18/103)적환자중검출료다발병조,51.7%(12/21)적전이성저골류환자재골현상상부표현저골단발병변.저골종류표현위방사성감저형자재평면현상중점46.6%(48/103),재단층현상중점84.6%(33/39).방사성농취형혹반국부농취적방사성감저형저골종류다위악성병변;이단순적방사성감저형저골종류재무다골병변발생적정황하다위량성병변;정현"작면권"정적저골종류칙다위골거세포류.결론 저골종류술전골현상유조우전신다발병변적사사,단대우단발적전이성종류기진단개치유한;관찰종류대현상제적섭취특정,가위기감별진단제공방조.
Objective To evaluate the clinical significance of bone scintigraphy in the preoperative diagnosis of sacral tumor. Methods Preoperative 99Tcm-methylene diphosphonate (MDP) whole body bone scintigraphy was performed in total of 103 patients with sacral tumor for whole body survey and radionuclide uptake in the sacral tumor. Of these 103 patients,39 had SPECT. According to the osteoblastic reaction in bone SPECT studies,patterns of tumor with a "hot" lesion was defined as type Ⅰ,a "cold" lesion accompanied with partial uptake was defined as type Ⅱ,a purely "cold" lesion was defined as type Ⅲ,and a "cold" lesion with marginal uptake which produced "doughnut sign" was defined as type Ⅳ. Imaging interpretation was correlated with the final pathologic diagnosis. Results Of the 103 patients,18 ( 17.5% ) had polyostotic involvement. About 46.6% (48/103 ) in planar and 84.6% ( 33/39 ) in SPECT showed decreased uptake at sacrum. Of the bone metastatic patients (n =21 ) ,12 (51.7%) had sole metastasis to sacrum. Tumor with type Ⅰ (6/6) or type Ⅱ (16/19) uptake was likely to be a malignancy,whereas type Ⅲ uptake tended to occur in the benign disease in those patients without polyostotic involvement( 5/7 ),and type Ⅳ was all appeared in giant cell tumors( n = 5 ). Conclusions Preoperative bone scintigraphy is useful in examination of polyostotic involvement for the patients with sacral tumor,but it is limited for diagnosing isolated sacral metastatic disease. Tumor uptake on bone scintigraphy can be helpful in differential diagnosis of sacral tumor.
