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以往认为,骨肉瘤截肢术后首先发生转移的部位是肺而非骨,故用放射线核素骨显象来寻找骨转移灶并无意义。随着疗效的改善以骨最先发生转移的情况也见增多,故应重新评价骨显象的作用。本文作者对55例骨肉瘤患者作了全身T_c~(99)骨显象,大部分于术前和术后每3—4个月进行一次,共计显象291次。患者就诊时远处骨转移和肿瘤在髓腔内跳跃式蔓延的发生率很低(仅2148)。术后随诊的47例中,20例发生了骨转移,骨显象均阳性,其中7例为骨首先出现转移,12例先有肺转移而后骨转移,1例肺和骨同时出现转移。此20例中11例当时尚无骨
In the past, it was considered that the site of metastasis of osteosarcoma after the first amputation was lung rather than bone. Therefore, it is not meaningful to use radionuclide bone imaging to search for bone metastases. With the improvement of curative effect, the first occurrence of bone metastasis also increases, so the effect of bone imaging should be re-evaluated. The authors performed whole-body T_c 99 bone imaging on 55 patients with osteosarcoma. Most of them were performed 3-4 times before and after surgery every 3-4 months. The incidence of distant bone metastasis and tumor leaps in the medullary cavity at the time of the patient’s visit was very low (2148 only). Of the 47 patients following follow-up, 20 had bone metastases and all had bone metastases. Among them, 7 had first metastasis of bone, 12 had first metastasis and then metastasis, and 1 had metastasis at the same time. Of these 20 cases, 11 cases were not