肿瘤放射治疗部位核素骨显像特征

Characteristic findings of bone scintigraphy after radiation therapy for cancer

目的： 探讨恶性肿瘤患者放射治疗部位骨显像的放射性分布改变。方法：５３ 例乳腺癌、３０ 例鼻咽癌、４９ 例肺癌、２２ 例食管癌患者行９９ｍ Ｔｃ－ ＭＤＰ全身骨显像， 对放射治疗部位骨显像剂浓聚的情况进行观察分析。结果： １５４ 例患者中７７ 例（５０％ ）放射性浓聚异常。其中４７ 例（３０－５％）局部软组织浓聚， ３２ 例（２０－８％） 局部骨放射性浓聚减低，１２ 例（７－８％）局部骨放射性浓聚增高。８ 例有两种改变，３ 例有三种改变。照射剂量＜３０Ｇｙ 组与≥３０Ｇｙ 组间显像剂浓聚异常有显著性差异（Ｐ＜ ０－０５）。结论： 放射治疗可引起骨、软组织浓聚显像剂异常， 询问患者的放射治疗史对骨显像结果的正确诊断非常必要。

Objective:To evaluate the changes of radiopharmaceutical uptake in the radiation portal on whole body bone scintigraphy.Methods:53 patients with breast cancer,30 patients with nasopharyngeal cancer,49 patients with lung cancer and 22 patients with esophageal cancer were studied to investigate the changes of distribution of 99mTc-methylene diphosphonate(MDP) in the irradiated port.Results:77 out of 154 patients were abnormal in the irradiated region.47 patients(30.5%)had soft-tissue accumulation of 99mTc-MDP.32 patients(20.8%) showed photopenic abnormalities on whole body bone scintigraphy.12 patients(7.8%) demonstrated increased activity in the irradiated region.8 patients showed two kinds of abnormalities and 2 patients had 3 ones.The difference of imaging agent uptake between bone dose <30Gy and ≥30Gy was significant(P<0.05).Conclusions:The abnormalities of bone and soft-tissue uptake are observed in the irradiated region.Knowledge of a patients radiotherapy history is an important prerequisite for interpretation of subsequent bone scans.