骨纤维异常增殖症全身骨显像影像特征分析  

An Analysis of Features of the Whole-Body BoneImaging in Osteofibrous Dysplasia

作　　者：冯瑾[1] 张连娜[1] 高璇 陈瑞玲[1] 杨芳[1] FENG Jin;ZHANG Lianna;GAO Xuan;CHEN Ruiling;YANG Fang(Department of Nuclear Medicine,Beijing Jishuitan Hospital,Beijing 100035,China)

机构地区：[1]北京积水潭医院核医学科,北京100035

出　　处：《标记免疫分析与临床》2021年第9期1452-1456,1463,共6页Labeled Immunoassays and Clinical Medicine

摘　　要：目的研究骨纤维异常增殖症(OFD)患者的核素全身骨显像表现特征,探讨骨显像在诊断和鉴别诊断中的应用价值。方法回顾性研究2013年1月至2015年12月间122例经病理证实为OFD的患者,男61例,女61例,年龄4~69岁,平均28±14.1岁,分析这些患者全身骨显像的影像特征。结果、单骨型OFD患者占46.7%(57/122),受累部位前三位依次为,股骨29例(50.1%),胫骨16例(28.1%),肋骨5例(0.9%)。多骨型OFD占53.3%(65/122),单侧骨骼受累38例(58.5%),双侧骨骼受累27例(41.5%)。多骨型患者共发现病灶472处,受累部位前三位依次为肋骨94处(19.9%),股骨64处(13.6%),胫骨45处(9.5%)。单骨型OFD全身骨显像表现为轻度到高度异常放射性增高,病变特征不明显。多骨型OFD在四肢长骨多表现为沿骨长轴走行的异常放射性浓聚,放射性增高可见截段样分布,股骨上段受累,可见“羊拐征”表现;肋骨受累表现为沿肋骨长轴分布的条状放射性增高,多肋骨受累呈连续分布特征;颅面骨、骨盆、脊柱多表现为块状放射性浓聚;多骨受累有单侧骨骼受累趋势,若双侧受累表现为一侧病灶多于对侧,或表现为一侧骨病变放射性浓集程度高于对侧。结论全身骨显像是诊断OFD的一种重要的影像手段,可评价骨骼受累范围,多骨型典型影像表现,有助于OFD的诊断及鉴别诊断。Objective To summarize the bone imaging features of osteofibrous dysplasia(OFD),and investigate the diagnostic value of bone imaging in the diagnosis and differential diagnosis.Methods Bone scans were performed in 122 cases of OFD patients proven pathologically during the period of January,2013 to December,2015.A retrospective study method was applied to analyze the imaging results.Results 46.7%(57/122)cases had lesions localized in only one bone location(monostotic).The top three affected area were femur 29(50.1%),tibia 16(28.1%),and rib 5(0.9%).53.3%(65/122)cases had them in multiple bone locations(polyostotic).38 cases(58.5%)were unilateral skeletal involved,and 27 cases(41.5%)were bilateral skeletal involved.472 lesions were identified in polyostotic,and the top three affected areas were rib 94(19.9%),femoral 64(13.6%),and tibia 45(9.5%).Single bone OFD bone imaging showed mild to high abnormal radioactivity,and the characteristics were not obvious.In polyostotic cases,the long bones of the limbs showed along the long axis of the bone abnormal radioactive concentration,with increased radioactivity visible section of the sample distribution and the involvement of the proximal femur,visible"dibs"sign performance.Rib involvement was distributed along the long axis of the rib strips with radioactive increased.Ribs by tired showed a continuous distribution.Craniofacial bones,pelvis and spine showed clustered for massive radioactive concentration.Multiple bone involvement showed an unilateral skeletal involvement trend.If it was bilateral involvement,performance unilateral lesions were higher on the other side of the lesion,or performance for one side of bone lesions radioactive concentration degree was higher than the other side.Conclusion The whole-body bone imaging is an important imaging approach for the diagnosis of OFD.It can be used to evaluate the extent of skeletal involvement.The typical imaging features of multiple bone involved is helpful for the diagnosis and differential diagnosis of OFD.

关 键 词：骨纤维异常增殖症 体层摄影术 发射型计算机 单光子 骨显像 

分 类 号：R817.4[医药卫生—影像医学与核医学]