变形性骨炎椎体“ Mouse Face”样图像分析

The "Mouse Face" Appearance of the Vertebrae in Paget's Disease

目的：探讨变形性骨炎病因诊断和治疗方案。材料与方法：随机选择骨显像图２８８３例。由２名医生读片，以图像表现为在椎体中心和两侧横突浓集增高，由三个点状影构成一倒置三角形者被确认为“Ｍｏｕｓｅ Ｆａｃｅ”样图像特征而作为分析对象。并根据近似和酷似“Ｍｏｕｓｅ Ｆａｃｅ”的程度分为Ⅰ度和Ⅱ度。结果：“Ｍｏｕｓｅ Ｆａｃｅ”样图像６０例， Ⅰ和Ⅱ度分别为２４和３６例，变形性骨炎占 ４２例，骨转移癌占 １４例，其它疾病４例。结论：“Ｍｏｕｓｅ Ｆａｃｅ”图像对变形性骨炎的诊断比肿瘤骨转移更具有启发性。变形性骨炎阳性预测值为 ７０％，如果没有其他放射学检查证实有转移灶，骨显像出现Ｍｏｕｓｅ Ｆａｃｅ”样图像应肯定其诊断。

Purpose: Our purpose is to discuss which causes a diagnostic and a plan to therapeutic. Material and Methods: Bone scans performed in 2883 patients were randomly selected and reviewed by 2 physicians. The 'Mouse Face' appearance is increased tracer uptake in the entire verterbrae and processus transversus which form and inverted triangular pattern of three dots that resembles the 'Mouse Face' silhouette. The 'Mouse Face' appearance were divided into two grades according to the uptake in vertebrae and processus transversus. Results: sixty cases with a 'Mouse Face' appearance were identified. 24 patients had gradeⅠ and 36 patients had grade Ⅱ 42 patients Paget's disease; 14 patients had metastases; and 4 patients had other diseases. Conclusions: The 'Mouse Face' appearance is more suggestive of Paget's disease than metastases even in patients with cancer. These patients should be assumed unlikely to have vertebral metastases. Unless proven by another correlative radiologic study. The positive predictive value for Paget's disease was 70 %.