SPECT/CT骨显像在钙化防御诊断中的应用价值  

Value of SPECT/CT bone imaging in the diagnosis of calciphylaxis

作　　者：汤元翔 栗全营 徐玄飞 王强[2] 杨桂芬 TANG Yuanxiang;LI Quanying;XU Xuanfei;WANG Qiang;YANG Guifen(Medical School of Nanjing University, Nanjing 210046, China;Department of Nuclear Medicine, Zhongda Hospital, Southeast University, Nanjing 210009,China;Department of Nuclear Medicine, Jinling Hospital of Eastern Theater Command, Nanjing 210002,China)

机构地区：[1]南京大学医学院,江苏南京210046 [2]东南大学附属中大医院核医学科,江苏南京210009 [3]东部战区总医院核医学科,江苏南京210002

出　　处：《东南大学学报（医学版）》2021年第2期202-206,共5页Journal of Southeast University(Medical Science Edition)

基　　金：江苏省“科教强卫工程”青年医学重点人才项目(QNRC2016913)。

摘　　要：目的:探讨^(99m)锝-亚甲基二膦酸盐(^(99m)Tc-MDP)单光子发射型断层扫描/X线计算机断层扫描(SPECT/CT)骨显像在钙化防御中的诊断价值。方法:回顾性分析东南大学附属中大医院2017年11月至2020年5月临床病理确诊为钙化防御的17例患者的^(99m)Tc-MDP SPECT/CT骨显像检查资料,根据患者临床资料及^(99m)Tc-MDP SPECT/CT骨显像结果分析其临床特点及影像学表现。结果:17例钙化防御患者16例出现骨外异常摄取^(99m)Tc-MDP,阳性率为94.1%,仅1例SPECT/CT显像无阳性表现,阴性率为5.9%。部分患者表现为多脏器的累及,其中累及躯干、四肢皮肤8例,占总病例的47.1%,表现为病变处皮肤增厚,皮下可见软组织团块、结节、钙化、炎性渗出等,病变区域放射性摄取不同程度增高。多器官受累5例,占总病例的29.4%,表现为皮肤及皮下组织、骨骼肌、心肌、肺放射性异常增高,其中1例患者经硫代硫酸钠治疗后,临床表现及SPECT/CT骨显像表现均明显减轻。另累及阴茎1例。结论:钙化防御患者^(99m)Tc-MDP SPECT/CT骨显像有其特定的影像学表现,SPECT/CT骨显像对于钙化防御患者有重要的诊断价值。Objective:To investigate the value of ^(99m)Technetium-methylene diphosphonate(^(99m)Tc-MDP)single photon emission computed tomography/computed tomography(SPECT/CT)bone imaging in the diagnosis of calciphylaxis.Methods:The data of ^(99m)Tc-MDP SPECT/CT bone imaging of 17 patients with calciphylaxis confirmed by pathology in Zhongda Hospital of Southeast University from November 2017 to May 2020 were retrospectively analyzed.According to the clinical data and ^(99m)Tc-MDP SPECT/CT bone imaging results,the imaging manifestations and clinical characteristics were analyzed.Results:16 of the 17 patients with calciphylaxis had extraosseous uptake at the lesion site,the positive rate was 94.1%,only 1 patient had no positive manifestation on SPECT/CT,and the negative rate was 5.9%.Some of the patients showed involvement of multiple organs,including 8 cases involving the skin of trunk and limbs,accounting for 47.1%of the total cases,presenting thickening of the skin at the lesion site,subcutaneous soft tissue masses,nodules,calcification and inflammatory exudation,etc.The radiation uptake in the lesion area increased to varying degrees.There were 5 cases with multiple organ involvement,accounting for 29.4%of the total cases,showing abnormal increase of radioactivity in skin and subcutaneous tissues,skeletal muscle,heart muscle and lung.The clinical manifestations and SPECT/CT bone imaging were significantly reduced in 1 patient treated with sodium thiosulfate.The penis was involved in another case.Conclusion:^(99m)Tc-MDP SPECT/CT bone imaging has its special features in patients with calciphylaxis,which can provide important diagnostic value for patients with calciphylaxis.

关 键 词：钙化防御 ^(99m)锝-亚甲基二膦酸盐 单光子发射型计算机断层扫描 骨显像 骨外摄取 

分 类 号：R543[医药卫生—心血管疾病] R445.6[医药卫生—内科学]