骨显像上颌骨额突浓聚灶随访及CT对照分析

Maxillary Frontal Process Radionuclide Uptake on Bone Scan: A Follow-up and Comparison with CT Findings

目的部分肿瘤患者骨显像发现上颌骨额突单发放射性浓聚灶,诊断困难,并且相关研究较少。本文旨在探讨骨显像上颌骨额突放射性浓聚灶的性质及原因,以提高对该病变的认识。资料与方法选择上颌骨额突放射性浓聚但不伴其他骨转移瘤的21例患者,分析骨显像放射性浓聚灶的形态及分布,对比随访骨显像,观察病变有无变化,总结相应CT所见病变的部位、数目、大小、内部密度、边缘等形态学特点。结果 21例上颌骨额突浓聚灶累及单侧17例,双侧4例,1例伴其他颅骨病变。14例复查骨显像病变均未见变化,且未见新增病变。12例发现16个放射性浓聚灶,其中15个CT有异常表现,14个位于额突基底部鼻泪管周围。所有病变边界清楚,横截面最大径线平均7.1 mm。10个呈均匀磨玻璃密度,5个内部可见更低密度区。结论骨显像上颌骨额突浓聚灶倾向良性病变,CT提示骨纤维异常增生症样病变为导致异常浓聚的原因之一。

Purpose The increased radionuclide uptake of maxillary frontal process on bone scan is not uncommon but difficult to diagnose with relatively rare research. This study aims to explore this phenomenon through investigating its biological behavior and causes. Materials and Methods Twenty-one patients with increased uptake of maxillary frontal process but without typical feature of metastasis on bone scan were retrospectively enrolled in the study. The scintigraphic features were evaluated and compared with the bone scans in the follow up. The corresponding CT imaging features including the lesions＇ location, number, size, shape and attenuation were analyzed. Results Seventeen patients had unilateral involvement and 4 had bilateral ones. One patient was found accompanied with other cranial lesions. All the lesions remained stable and no new lesions were detected on the following bone scans in 14 patients. Sixteen lesions with increased radionuclide uptake in 12 patients were detected on bone scintigraphy, 15 of which were positive on CT and 14 of which were located around the nasolacrimal canal at the base of frontal process. All the lesions were well demarcated with mean axial maximum diameter of 7.1 mm. Ten had homogeneous ground-glass density and 5 showed heterogeneous with internal lower attenuation. Conclusion Lesions of maxillary frontal process with increased radionuclide uptake detected on bone scan are likely to be benign. Fibrous dysplasia-like lesions might help account for abnormal uptake indicated by CT.