横纹肌肉瘤骨三相联合SPECT/CT融合多模态显像特征  

Rhabdomyosarcoma three-phase bone scintigraphy combined SPECT/CT fusion imaging in 1 case and the literature review

作　　者：宋德炜 方娟娟 邵元伟 刘廷洲 滕敏敏 王瑞卿 孙文虎 SONG Dewei;FANG Juanjuan;SHAO Yuanwei;LIU Tingzhou;TENG Minmin;WANG Ruiqing;SUN Wenhu(Nuclear Medicine Department,Dezhou City Second People's Hospital,Dezhou,Shandong 253000,China)

机构地区：[1]德州市第二人民医院核医学科,山东德州253000

出　　处：《影像研究与医学应用》2023年第21期20-23,共4页Journal of Imaging Research and Medical Applications

基　　金：山东省医药卫生科技发展计划项目(202109041079)。

摘　　要：目的:探讨横纹肌肉瘤(RMS)^(99m)Tc-亚甲基二磷酸盐(^(99m)Tc-MDP)多模态骨显像的影像学特征。方法:结合文献回顾性分析经穿刺病理证实的1例RMS,其骨三相联合单光子发射型计算机断层扫描仪(SPECT)/计算机体层成像(CT)融合多模态显像及磁共振成像(MRI)的影像学特征。结果:本例RMS MRI示右小腿近端软组织信号不均,增强检查呈不均质明显强化,右胫腓骨近端呈混杂信号改变。骨三相示血流相及血池相右小腿近端软组织血流明显增多。延迟相相应区域边缘骨代谢活跃,内部骨组织代谢降低。SPECT/CT融合多模态显像示右胫腓骨近端骨髓密度增高并病理性骨折,边缘骨代谢活跃,内部骨组织代谢降低。穿刺活检病理示:(右小腿穿刺组织)梭形细胞肿瘤,结合免疫组化,符合横纹肌肉瘤。结论:RMS骨三相联合SPECT/CT融合多模态显像有一定的特征,在判断病变的良恶性及病灶范围确定方面有较大的增益价值,最终诊断有赖于病理及免疫组化。Objective Study on imaging characteristics of ^(99m)Tc-methylenediphosphonate(^(99m)Tc-MDP)multimodal bone imaging in rhabdomyosarcoma(RMS).Methods Retrospective analysis of multimodal imaging and magnetic resonance imaging(MRI)features of three-phase bone scintigraphy combined single-photon emission computed tomography(SPECT)/computed tomography(CT)fusion in a case of RMS confirmed by puncture pathology combined with literature.Results In this case,RMS MRI shows uneven signal in the soft tissue of the proximal right calf.,and the enhancement examination showed heterogeneous and obvious enhancement,and the proximal right tibia and fibula presented mixed signal changes.Three-phase bone scintigraphy showed that blood flow and blood pool phase increased significantly in the proximal right calf soft tissue.The marginal bone metabolism of the corresponding area in the delayed phase is active,and the internal bone tissue metabolism is reduced.SPECT/CT fusion multimodal imaging showed that the bone marrow density of the proximal end of the right tibia and fibula is increased and pathological fracture occurs,the marginal bone metabolism is active,and the internal bone metabolism is reduced.The biopsy pathology showed that(the right leg puncture tissue)spindle cell tumor,combined with immunohistochemistry,was consistent with rhabdomyosarcoma.Conclusion RMS three-phase bone scintigraphy combined SPECT/CT fusion multimodal imaging has certain characteristics,and has greater value in judging benign and malignant lesions and determining the scope of lesions.The final diagnosis depends on pathology and immunohistochemistry.

关 键 词：横纹肌肉瘤 SPECT/CT 骨三相 MRI 

分 类 号：R445.5[医药卫生—影像医学与核医学]