1例软骨母细胞瘤三相骨显像表现为骨巨细胞瘤的误诊案例分析  

A Case of Misdiagnosed Chondroblastoma with Giant Cell Tumor of Bone in Three- Phase Bone Scintigraphy

作　　者：刘昱 郝婷婷[1] 熊晓亮[1] 石雪[1] 赵银龙[1] LIU Yu;HAO Tingting;XIONG Xiaoliang;SHI Xue;ZHAO Yinlong(Department of Nuclear Medicine,The Second Hospital of Jilin University,Changchun 130041,China)

机构地区：[1]吉林大学第二医院核医学科,吉林长春130041

出　　处：《标记免疫分析与临床》2022年第6期941-943,948,共4页Labeled Immunoassays and Clinical Medicine

摘　　要：目的 通过对1例软骨母细胞瘤(chondroblastoma, CB)误诊为骨巨细胞瘤病例的回顾性分析,为核医学工作人员和临床医生提供诊疗经验。方法 报道1例经病理确诊为软骨母细胞瘤,但X线平片、常规CT、核磁共振(MR)及核医学三相骨显像联合SPECT/CT断层融合显像均误诊为骨巨细胞瘤的病例,结合相关文献,探讨软骨母细胞瘤三相骨显像联合SPECT/CT融合显像的影像学特征。结果 软骨母细胞瘤在三相骨显像中血池相、血流项及延迟相均为阳性,临床诊断时应该注意与骨巨细胞瘤进行鉴别。结论 软骨母细胞瘤与骨巨细胞瘤是两类不同的疾病,但影像上略有相似,核医学医生应该分析三相代谢特征以及SPECT/CT融合影像特征,并通过临床资料给出正确的诊断,对于无法确诊者,可通过手术或CT引导下穿刺获取病灶组织行病理检查以明确诊断,从而避免误诊误治。Objective To gain experience for nuclear medicine staff and clinicians in diagnosis and treatment through retrospectively analyzing a case of chondroblastoma(CB)misdiagnosed as giant cell tumor of bone.Methods A case of chondroblastoma diagnosed by pathology was reported, but X-ray plain film, conventional CT, magnetic resonance(MR)and nuclear medicine three-phase bone scintigraphy combined with SPECT/CT tomographic fusion imaging were all misdiagnosed as giant cells of bone. The imaging characteristics of three-phase bone scintigraphy combined with SPECT/CT fusion imaging in chondroblastoma were discussed based on the relevant literatures.Results Chondroblastoma was positive for the hemic pool phase, blood flow and delay phase in the three-phase bone imaging, and should be distinguished from bone giant cell tumor in clinical diagnosis.Conclusion Chondroblastoma and giant cell tumor of bone are two different diseases, but the images can be slightly similar. Nuclear medicine physicians should summarize and analyze the three-phase metabolic characteristics, as well as SPECT/CT fusion imaging characteristics, so to provide related clinical data to patients. To make a correct diagnosis, for those who cannot be diagnosed, the lesion tissue can be obtained by surgery or CT-guided puncture for pathological examination to confirm the diagnosis, thereby avoiding misdiagnosis and mistreatment.

关 键 词：软骨母细胞瘤 骨巨细胞瘤 三相骨显像 误诊 

分 类 号：R738.1[医药卫生—肿瘤]