国内对^(99m)Tc-MDP骨扫描前位图像中下颈部相对高摄取现象的认识调查和原因分析  

Investigation and reason analysis of domestic knowledge on relatively higher tracer uptake in neck in anterior image of ^(99m)Tc-MDP bone scanning

作　　者：李伟[1] 张汝森[1] 刘枫[1] 卢斌贵[1] 任志刚[1] 

机构地区：[1]广州医科大学附属肿瘤医院,广东广州510095

出　　处：《中国临床医学影像杂志》2015年第3期200-205,共6页Journal of China Clinic Medical Imaging

摘　　要：目的:调查国内对全身平面骨扫描前位图像的中下颈部相对高摄取区(RHTUN)的认识情况,并通过SPECT/CT分析其形成的原因。方法:分析2000年以后出版的20本核医学专业书籍、以"骨扫描"和"颈"为条件检索2000年至今的维普中文数据库、向203位成员组成的腾讯QQ群"快乐核医学"发出调查询问,调查国内的核医学专业书籍、核医学专业论文、核医学专业人员对于RHTUN现象的了解及其形成原因的认知情况。选择在同一天行全身平面骨扫描和颈部SPECT/CT断层融合显像的病例100例为研究样本,以SPECT/CT图像为定性标准,分析RHTUN的形成原因。结果:20本书籍均提及RHTUN。关于形成原因,18本书(90%)提到可能是"甲状腺异常摄取99mTc O4-",13本书(65%)提到还可能是"颈椎骨质增生而过多摄取放射性药物",8本书(40%)提到还可能是"喉部软骨钙化而异常摄取放射性药物"。维普中文数据库中共检索到14篇文献,其中有关的仅4篇,所有文献均与RHTUN无直接关系。通过"快乐核医学"共收到有效答复105份,105人(100%)均知道RHTUN。关于形成首要原因,72人(68.6%)首先考虑是"甲状腺摄取99mTc O4-",28人(26.7%)考虑是"颈椎骨质增生而过多摄取放射性药物",5人(4.8%)考虑是"喉部软骨钙化而异常摄取放射性药物"。在100例样本中,88例出现RHTUN。其中88例(100%)在SPECT/CT图像中均出现颈椎放射性浓聚,以椎间盘附近、椎体后缘放射性水平更高;88例(100%)出现喉部软骨放射性分布,放射性水平都不超过颈椎骨本底放射性水平;88例(100%)均未出现甲状腺异常放射性分布。88例RHTUN中63例呈长条型,其中存在颈椎增生(明确41例、可疑7例、无15例)和椎间盘异常(明确27例、可疑8例、无28例);局灶型25例,其中存在颈椎增生(明确14例、可疑4例、无7例)和椎间盘异常(明确17例、可疑5例、无3例)。2型之间在颈椎增生方面不存在显著性差异,在椎间盘�Objective： To investigate the reasons for domestic knowledge about neck＇s relatively higher tracer uptake （RHTUN） in anterior image of 99mTc-MDP whole body scanning by SPECT/CT. Methods： After investigating the domestic nu- clear medicine professional books and papers for understanding RHTUN and its reasons, analyzing 20 nuclear medicine pro- fessional books published after 2000, searching VIP Chinese database with conditions of ＂bone imaging＂ and ＂neck＂, and sending questionnaire survey to the Tencent QQ group ＂happy nuclear medicine＂ with 203 members, 100 cases of whole body bone imaging and neck SPECT/CT in one day were enrolled in the study. SPECT/CT findings were taken as the qualitative standard to analyse the causes for RHTUN. Results： All 20 books mentioned RHTUN. On the cause of formation, 18 books （90%） referred to ＂abnormal thyroid uptake of 99mTcO4, 13 books（65%） referred to ＂cervical bone hyperplasia and excessive intake of radioactive drugs＂, 8 books（40%） referred to ＂throat cartilage calcification and abnormal uptake of radioactive drugs＂. Only 4 of 14 papers in VIP Chinese database were correlated but not directly related with RHTUN. A total of 105 copies of effective response were got from ＂happy nuclear medicine＂, and 105 （100%） all knew RHTUN. About the primary cause of RHTUN, 72（68.6%） supported ＂thyroid uptake of 99mTcQ, 28（26.7%） supported ＂cervical bone hyperplasia and excessive in- take of radioactive drugs＂, and 5（4.8%） supported the ＂throat cartilage calcification and abnormal uptake of radioactive drugs＂. In the 100 eases, 88 eases showed RHTUN. 88 eases （100%） showed cervical radioactive concentration in SPECT/CT image with higher radioactive level near intervertehral disc and the posterior side of vertebral body. In 88 cases（100%） of radioactiv- ity distribution in the laryngeal cartilage, the radioactive level was not more than the background level in the cervical verte- bra. All 88 eases （100%） s

关 键 词：甲状腺 颈椎 体层摄影术 发射型计算机 单光子 99M锝美罗酸盐 

分 类 号：R581[医药卫生—内分泌] R681[医药卫生—内科学]