论文部分内容阅读
目的讨论99m锝-亚甲基二磷酸盐(99m Tc-MDP)全身骨显像对不明骨痛患者的诊断价值。方法对150例不明骨痛患者进行99m Tc-MDP全身显像,分析其影像表现特点。结果 150例全身骨显像中阳性123例(82.0%),病灶以多发为主。81例骨转移患者中骨显像阳性73例(90.1%),病灶表现为非对称性、不规则放射性核素异常浓聚,主要累及中轴骨。原发恶性骨肿瘤病灶以单发为主,主要分布于四肢与胸、腰椎,多呈团块状放射性核素异常浓聚,极少见放射性稀疏、缺损。多发性骨髓瘤病灶多分布于肋骨、椎体,大部分表现为放射性核素异常浓聚,少数表现为放射性稀疏或缺损合并浓聚,呈“炸面圈”改变,颅骨累及较少。骨结核病灶主要分布于脊柱、骨盆及四肢,放射性核素异常浓聚及缺损并存。骨良性病变可见胸骨、腰椎及骨盆多发病灶,放射性分布不均匀,形态不规则。结论 99m Tc-MDP全身骨显像应作为不明骨痛患者首选常规检查方法 ,能较早期发现骨骼异常,尤其对转移瘤的早期诊断有较高的临床价值。
Objective To discuss the diagnostic value of 99mTc-methylene diphosphate (99m Tc-MDP) whole body bone imaging in patients with unknown bone pain. Methods 150 cases of unknown bone pain in patients with 99m Tc-MDP whole body imaging, analysis of its imaging features. Results In 150 cases of bone scintigraphy, 123 cases were positive (82.0%). The main lesions were multiple. In 81 cases of bone metastases, 73 cases (90.1%) were positive for bone imaging. The lesions showed asymmetry and abnormal radionuclides were abnormally concentrated, mainly involving the central axis bone. Primary malignant bone tumor lesions mainly single, mainly in the limbs and thoracic and lumbar spine, mostly clustered radionuclide abnormal concentration, rare radioactive sparse, defect. Multiple myeloma lesions are mostly located in the ribs, vertebral body, most of the performance of abnormal concentration of radionuclides, a small number of manifestations of radioactive sparse or defect with enrichment, was “donut ” change, fewer skull involvement. Bone tuberculosis lesions are mainly located in the spine, pelvis and limbs, radionuclide abnormalities and defects co-exist. Bony benign lesions can be seen sternal, lumbar and pelvic multiple lesions, uneven distribution of radioactivity, irregular shape. Conclusion 99m Tc-MDP whole body bone scintigraphy should be the first choice of routine examination for patients with unknown bone pain, which can detect skeletal abnormalities earlier, especially for the early diagnosis of metastatic tumors.