肺癌肥大性肺性骨关节病的核素骨显像特征

Characteristic findings of bone scintigraphy for hypertrophic pulmonary osteoarthropathy with lung cancer

评价肺癌肥大性肺性骨关节病(HPO)核素骨显像的特征,以利于鉴别肺癌骨转移和 HPO。对1 537例肺癌^(99m)Tc-亚甲基二膦酸盐核素骨显像中诊断 HPO 的51例进行分析,观察有无"双条"征表现;将四肢骨、肩胛骨、锁骨、颅骨、肋骨、骨盆和髌骨的放射性聚集程度参照 Ali 方法分级;注意外周骨关节内和周围有无异常放射性浓聚。51例四肢长骨均有"双条"征表现,其中8例(15.7%)伴有不对称性皮质放射性增加;44例行全身骨显像的 HPO 患者中,下肢放射性增加较上肢明显,27例(61.4%)有关节周围对称性放射性浓聚。"双条"征为 HPO 主要显像特征,骨转移癌与 HPO 的分布完全不同。

PURPOSE To differentiate the bone metastases and hypertrophic pulmonary osteoarthropathy (HPO) of lung tu- mor in bone scintigraphy,characteristic findings for HPO with lung cancer were assessed.METHODS ^(99m)Tc-MDP bone scinti- gram of 1537 patients with lung cancer were reviewed.Among them 51 HPO cases were confirmed by ^(99m)Tc-MDP bone scan. Their characteristic double-stripe sign was analyzed.The bones of extremities,scapulae,clavicles,skull,ribs,pelvis and patella were graded for radioactivity accumulation referring to Ali's method.Also,it was noticed whether or not there was an abnormally increased activity in and around the joints of the peripheral skeleton.RESULTS There was double-stripe sign in all 51 cases which was localized mainly along long bones,among them asymmetrical increase in activity along cortical margins in 8 cases (15.7%) was accompanied.Increase in activity in the lower extremities was greater than in the upper extremities in 44 cases,and a symmetrical increase in activity of periarticular regions in 27 cases (61.4%) was found.CONCLUSIONS Double-stripe sign is a main characteristic finding for HPO.The distribution of metastases and HPO in lung tumor was entirely different.