骨外软组织异常摄取骨显像剂的临床意义

Clinical significance of abnormal nonosseous soft tissue uptake of bone tracer

目的探讨骨外软组织异常摄取骨显像剂的临床意义。方法将全身骨显像示软组织异常摄取骨显像剂(99)~Tc^m-亚甲基二膦酸盐(MDP)的30例患者显像结果与其手术病理和(或)CT、MRI、X 线、超声及肠镜等检查结果对照,分析异常摄取(99)~Tc^m-MDP 的临床意义。结果 30例患者中肝摄取9例,其中弥散性摄取7例(6例为巨块型肝癌,1例为肝癌并结节性肝硬化),局灶性摄取2例(1例为转移性肝癌.1例为原发性肝癌);肺摄取5例,均为局灶性,4例为肺癌,1例为转移性肺癌;结肠摄取5例,1例弥散性伴局灶性摄取增高为血吸虫病,余4例原因不明;皮下摄取4例,2例对称性摄取者为多发性骨髓瘤患者钙磷代谢异常引起的转移性微小钙化灶,2例不对称摄取者1例为血管瘤,1例为脓肿;胸膜摄取3例,均为转移癌;腹部摄取3例,1例为网膜转移,1例为椎旁软组织转移,1例原因未明;乳腺摄取1例为乳腺癌。结论多种原因均可致骨外软组织异常摄取(99)~Tc^m-MDP,应结合临床或其他检查综合判断。

Objective To evaluate the clinical significance of abnormal soft tissue uptake of bone tracer. Methods Thirty patients with abnormal soft tissue uptake of bone tracer on ^99Tc^m-methylene diphosphonic acid （MDP） skeletal imaging were analyzed. Radioactivity of soft tissue accumulated equal to or greater than the ribs were considered as abnormal. The result was compared with pathology, MRI, CT, X-ray, ultrasound, findings for evaluating its clinical significance. Results In 7 patients with diffuse liver uptake of ^99Tc^m-MDP, 6 were massive and 1 nodular liver cancer. In 2 patients with local liver uptake, one was metastatic and the other primary liver cancer. In 5 local lung uptake cases 4 were primary lung cancer and one metastatic. In 5 cases with colonic uptake 1 was schistosomiasis while the other 4 unexplainable. Subcutaneous tissue uptake was observed in 4 patients, symmetrical uptake in 2 patients with metastatic calcification microfoci in multiple myeloma, unsymmetrical uptake in 2 patients with hemangioma and abscess. Pleural uptake in 3 patients all was metastatic cancer. Abdominal uptake in 3 patients was omentum, para- vertebral soft tissue metastasis and unknown cause. Breast uptake in one patient was due to breast cancer. Conclusions There are many causes resulting in abnormal nonosseous soft tissue uptake of ^99Tc^m-MDP. The final diagnosis should correlate with clinical data and other examinations.