肿瘤患者骨外软组织摄取骨显像剂的临床意义

Clinical significance of nonosseous soft tissue uptake of bone trace in cancer patients

目的探讨肿瘤患者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99Tcm-MDP的20例患者显像结果与其手术病理和(或)CT、MRI等影像检查结果进行对照,分析异常摄取99Tcm-MDP的临床意义。结果20例患者中肺摄取7例,其中弥漫性摄取1例为转移癌,局灶性摄取6例(3例肺癌,1例乳癌肺转移,1例肺错构瘤,1例肺炎性假瘤);胸膜弥漫性摄取3例均为转移癌,其中肺癌转移2例,乳癌转移1例;脑局灶性摄取5例,均为脑转移癌;乳腺摄取2例,原发乳癌和乳腺癌复发各1例;鼻咽部摄取2例均为鼻咽癌;肾脏摄取1例为肾癌。各种原发癌和转移癌对骨显像剂的异常摄取占90%(18/20);摄取部位以肺脏、胸膜及头部居多,占85%。结论骨外软组织对骨显像剂99Tcm-MDP的异常摄取主要见于原发癌或转移癌,具有一定的临床意义,值得关注。

Objective To explore the clinical significance of abnormal soft tissue uptake of bone tracer in cancer patients. Methods Twenty patients with abnormal soft tissue uptake of bone tracer on ^99Tc^m-methylene diphosphonic acid （MDP） skeletal imaging were analyzed. The result was compared with pathology, MRI, CT, finding for evaluating its clinical significance. Results In 20 cases of patients with abnormal soft tissue uptake of bone tracer, 7 cases were with abnormal lung up-take of ^99Tc^m-MDP. In which, one case with diffuse lung uptake was metastatic lungs cancer, 6 cases with local lung uptake were 3 cases of primary lung cancer, 1 case of metastatic lung cancer from breast, 1 case of hamartomas, and 1 case of in-flammatory pseudotumor. Pleural diffuse uptake in 3 patients was all metastatic pleural cancer, in which 2 cases from lung cancer and 1 case from breast cancer. Brain local uptake in 5 cases was all metastatic brain cancer. Breast uptake was 2 cases, one of primary breast cancer and another of breast cancer recurrence. Two cases with nasopharygeal abnormal uptake were all nasopharygeal cancer. 1 case kidney uptake was kidney cancer. In 20 patients with abnormal soft tissue uptake of bone tracer, patients of various primary and metastatic cancer were 18 cases （90. 0%）. The position of abnormal soft tissue uptake was mainly on lung, pleural and head （85%）. Conclusion The nonosseous soft tissue abnormal uptake of bone trac er ^99Tc^m-MDP has certain clinical significance. In cancer patients, the existence of malignant tumors in soft tissues should be considered first.