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目的探讨核素骨扫描在儿童神经母细胞瘤(NB)临床分期和疗效评价中的应用价值。方法2001-01—2005-09对解放军总医院小儿内科住院的NB患儿36例,在系统治疗前均行99mTc-亚甲基二磷酸盐(99mTc-MDP)全身骨扫描;其中13例骨扫描阳性患儿在治疗及随访过程中行2~4次全身骨扫描,观察骨转移的消退情况,一般在5~6疗程诱导化疗后复查;6例行自体外周血干细胞移植的患儿在移植前、后分别复查骨扫描。结果36例患儿中骨扫描阳性23例(63.9%),四肢长骨、脊柱、颅骨、骨盆、肋骨、肩胛骨受累分别为15,12,9,6,5和1例次,其中18例表现为多发阳性灶(78.3%)。13例随访患儿中,其中8例经5~6疗程诱导化疗后骨扫描异常浓聚灶范围缩小、浓聚程度减轻,表明病灶修复,治疗有效;5例患儿放射性浓聚灶无变化或增加,表明病情无变化或进展,治疗无效。结论核素骨扫描为NB诊断及临床分期提供更准确的信息,并有助于疗效评价和预后判断。
Objective To investigate the clinical value of radionuclide bone scan in the evaluation of clinical stage and efficacy of neuroblastoma (NB) in children. Methods From January 2001 to September 2005, 36 children with NB who were hospitalized in Department of Pediatrics, People’s Liberation Army General Hospital were enrolled in this study. 99mTc-methylene diphosphate (99mTc-MDP) whole-body bone scans were performed before systematic treatment. Positive children during the treatment and follow-up during 2 to 4 times the whole body bone scan to observe the regression of bone metastases, usually 5 to 6 courses of chemotherapy after the review; 6 cases of autologous peripheral blood stem cell transplantation in children before transplantation, After review bone scan. Results Totally 23 cases (63.9%) had bone scan in 36 cases. The length of the long bones, spine, skull, pelvis, ribs and scapula of the limbs were 15, 12, 9, 6, 5 and 1 times respectively. Multiple positive lesions (78.3%). Thirteen children were followed up, of which 8 cases after 5 ~ 6 courses of chemotherapy induced bone sclerosis abnormal focus range narrowed, the concentration decreased, indicating that the lesion repair and effective treatment; 5 cases of children with no change in radioactive focus or Increase, indicating no change in condition or progress, treatment is invalid. Conclusions Radionuclide bone scan provides more accurate information for the diagnosis and clinical stage of NB, and is helpful to evaluate the curative effect and prognosis.