全身骨显像联合 SP ECT／CT 显像对骨纤维异常增殖症的诊断价值  

Diagnostic value of whole-body bone scan combined with SPECT/CT imaging for osteofibrous dys-plasia

作　　者：李艳梅[1] 杨吉琴[1] 王莹[1] 李娟[1] 赵倩[1] 庄晓青[1] 刘保军[1] 张帆[1] 

机构地区：[1]宁夏医科大学总医院核医学科,银川750004

出　　处：《中华核医学与分子影像杂志》2015年第6期470-473,共4页Chinese Journal of Nuclear Medicine and Molecular Imaging

摘　　要：目的：评价全身骨显像联合SPECT／CT显像在骨纤维异常增殖症（OFD）中的临床应用价值。方法回顾性研究2007年6月至2014年12月间30例经病理证实为OFD的患者[男14例，女16例，年龄10～48（平均29．2）岁]，分析这些患者全身骨平面显像及局部SPECT／CT显像的影像特点。结果单骨型OFD患者占63．3％（19／30），以四肢骨受累多见（18例），尤其以股骨多见；多骨型OFD占36．7％（11／30），以身体一侧受累多见（7例）。绝大多数病患骨（95．3％，81／85）在全身骨平面显像上表现为明显或高度异常放射性浓聚影，四肢骨、肋骨多表现为沿骨干走行的异常放射性浓聚，颅骨、骨盆、脊柱多表现为块状放射性浓聚。 SPECT／CT显像的表现：明显或高度异常放射性浓聚影的CT相应部位多以囊性膨胀性生长、磨玻璃样改变、丝瓜络样改变及混合型改变为主，且放射性浓聚程度越高，CT形态学变化越大；中度或轻度放射性浓聚影的CT相应部位密度及形态学变化不大。结论全身骨显像联合SPECT／CT显像对诊断OFD有一定价值。Objective To explore the diagnostic value of whole-body bone scan combined with SPECT/CT imaging for osteofibrous dysplasia（ OFD） . Methods A total of 30 patients （ 14 males, 16 fe-males, age range 10-48 （ average age 29.2） years） with OFD confirmed by pathology from June 2007 to De-cember 2014 were included. The images of whole-body bone scan and SPECT/CT imaging were retrospec-tively analyzed. Results Nineteen patients （63.3%, 19/30） showed monostotic OFD, which mainly in-volved extremities （n=18）, especially the femur. Eleven patients（36.7%, 11/30） showed polyostotic OFD, which frequently be seen unilaterally （n=7）. Highly or obviously abnormal uptakes of radiotracer were shown in most lesions （95.3%, 81/85） on whole-body bone planar images, the ribs and extremities showed abnormal uptake along the backbone orientation, while the cranium, pelvis and spine showed irregu-lar bulky uptake of radioactivity. On SPECT/CT images, the lesions of high or obvious abnormal uptake of radiotracer mainly showed cystic expansion growth, ground glass, vegetable sponge and mixed appearance;and the higher the radioactive aggregation degree was, the more the morphological changes were. The density and morphological changes on CT were not obvious for lesions with moderately and mildly abnormal uptake of radiotracer. Conclusion The whole-body bone scan combined with SPECT/CT imaging is an effective diag-nostic method for OFD.

关 键 词：骨疾病 发育性 放射性核素显像 体层摄影术 发射型计算机 单光子 体层摄影术  X线计算机 MDP 

分 类 号：R681[医药卫生—骨科学]