^(99)Tc^m-MDP SPECT/CT断层显像在骨巨细胞瘤中的诊断价值  

Diagnostic value of 99Tcm-MDP SPECT/CT tomography for giant cell tumor of bone

作　　者：杨吉琴[1] 李艳梅[1] 王凤魁 王蓉[1] 王莹[1] 赵倩[1] 何丽荣[1] 杨鹏飞[1] 李娟[1] YANG Jiqin;LI Yanmei;WANG Fengkui;WANG Rong;WANG Ying;ZHAO Qian;HE LiRong;YANG Pengfei;LI Juan(Department of Nuclear Medicine,General Hospital of Ningxia Medical University,Yinehuan 750004,China)

机构地区：[1]宁夏医科大学总医院核医学科,宁夏银川750004

出　　处：《宁夏医学杂志》2018年第12期1069-1072,共4页Ningxia Medical Journal

摘　　要：目的探讨骨巨细胞瘤(GCT)的单光子发射断层显像/X线计算机断层显像(SPECT/CT)影像表现,旨在提高对此病的认识。方法回顾性分析31例经病理证实为GCT患者的SPECT/CT图像特点,分析其在骨显像及SPECT/CT的影像特征。结果 GCT好发于四肢长骨骨端(64. 5%,20/31),股骨远端和胫骨近端多见,椎体和髂骨为中轴骨GCT的常见部位。绝大部分病灶(96. 8%,30/31)放射性摄取浓聚,大部分(74. 2%,23/31)呈高度放射性浓聚,部分(22. 6%,7/31)呈轻度放射性浓聚,少数呈放射性冷区(3. 2%,1/31)。四肢长骨灶绝大部分(95%,19/20)呈高度放射性浓聚,椎体灶常呈(87. 5%,7/8)轻度放射性浓聚。"炸面圈症"在GCT中明显多于弥漫性病变,分别为53. 3%和33. 3%。CT特征为:所有肿瘤呈囊性密度,大部分呈膨胀性(86. 6%)、偏心性(54. 8%)骨质破坏;骨壳多见(71. 0%),呈细线样、花边样和多层样,部分(48. 4%)病灶见短小骨嵴,软组织影少见(16. 1%),未见骨膜反应。SPECT显像中"炸面圈症"发生率高于骨平面显像,分别为83. 9%与53. 3%(χ~2=6. 63,P <0. 05)。结论锝-亚甲基二膦酸盐(99Tcm-MDP) SPECT/CT断层显像对诊断GCT有一定的价值。Objective To explore the imaging characteristics of 99 Tcm-MDP SPECT/CT tomography in patients with giant cell tumor of bone( GCT),in order to improve the understanding of this disease. Methods The imaging features of SPECT/CT in 31 patients with pathologically confirmed GCT were retrospectively analyzed. Results GCT is more common in the extremities of the long bone of the limbs 64. 5%( 20/30),distal femur and proximal tibia is more common. vertebral and ilium are common sites of the central axial bone of GCT. Most of the 96. 8%( 30/31) were radioactive uptake,most of which were highly radioactive( 74. 2%),some of which were mildly radioactive concentration 22. 6% and a few of which were radioactive cold zone3. 2%. The high uptake in extremities was95%( 19/20),while the light uptake is 87. 5%( 7/8) in the vertebral. Doughnut patter was more common than diffuse lesions in the GCT,53. 3% and 33. 3% respectively. CT features: all tumors have cystic density,most of which are expansive( 86. 6%),eccentric( 54. 8%) bone destruction. The bone shell was more common( 71. 0%),which was thin,lace-like and multi-layered. Some 48. 4%of the lesions showed short bone crest,soft tissue were rare( 16. 1%),and no periosteal reaction was observed. The incidence of doughnut in SPECT imaging was higher than that of bone plane imaging,which was 83. 9% and 53. 3%,respectively( χ~2= 6. 63,P < 0. 05).Conclusion 99 Tcm-MDP SPECT/CT bone imaging has certain value in the diagnosis of GCT.

关 键 词：骨巨细胞瘤 锝-亚甲基二膦酸盐 全身骨显像 

分 类 号：R730[医药卫生—肿瘤]