^99 Tc^m-MDP骨显像评估脊柱成骨细胞瘤

^99 Tc^m-MDP bone scintigraphy in evaluation of spinal osteoblastoma

目的观察脊柱成骨细胞瘤^99 Tc^m-MDP骨显像表现,探讨骨显像用于术后评估的价值。方法回顾性收集24例病理证实的脊柱成骨细胞瘤影像学及临床资料,分析其术前、术后骨显像及同期CT特点,对比骨显像及CT诊断成骨细胞瘤术后复发的价值。结果14例接受术前骨显像,病灶均呈显著浓聚,其中13例后位像显示较前位像清晰;11例接受同期CT扫描,病变长径1.3~4.2 cm,9例见膨胀性溶骨性破坏,内部可见钙化或骨样密度影;2例呈单纯骨样密度。12例接受术后骨显像,6例显示病变复发,其中5例呈显著浓聚、1例轻度浓聚,5例接受同期CT,其中4例呈骨样密度影,1例软组织密度影伴钙化;6例未见复发,3例骨显像呈放射性减低伴周围浓聚,1例轻度浓聚、1例放射性减低、1例未见异常,5例接受同期CT,1例示术区软组织影、2例碎骨片影、2例未见异常。结论原发及复发性脊柱成骨细胞瘤骨显像多呈显著放射性浓聚。骨显像可用于脊柱成骨细胞瘤术后评估及指导临床决策,术后骨显像阴性可排除肿瘤复发。

Objective To observe the^99 Tc^m-MDP bone scintigraphy manifestations of spinal osteoblastoma,and to explore the value of bone scintigraphy for postoperative evaluation.Methods Imaging and clinical data of 24 patients with pathologically confirmed spinal osteoblastoma were retrospectively analyzed.Pre-and postoperative bone scintigraphy and CT features of spinal osteoblastoma were observed.The diagnostic value of bone scintigraphy and CT in detecting postoperative recurrence of osteoblastoma were compared.Results Fourteen patients underwent preoperative bone scintigraphy,remarkably increased radioactive uptake were found in all cases,which were showed more clearly in posterior position than in anterior position in 13 cases.Eleven cases underwent CT scanning,the length of lesions were 1.3-4.2 cm,expansive osteolytic destruction with calcifications or osteoid densities were noticed in 9 cases,while pure osteoid density nodules were found in 2 cases.Postoperative bone scintigraphy was performed in 12 cases,recurrent lesions were detected in 6 cases of,including 5 cases of significant radioactive uptake and 1 case of mild uptake,CT showed bone like density shadow in 4 cases and soft tissue density shadow with calcification in 1 case.Six patients were found without recurrence by bone scintigraphy,presenting as internal decrease with peripheral increase of radioactive uptake in 3 cases,mild increase in 1 case,decrease in 1 case and no abnormality in 1 case.Five of these 6 cases underwent CT scanning at the same time,which showed soft tissue density in 1 case,bone fragments in 2 cases and no abnormality in 2 cases.Conclusion Most of primary and recurrent spinal osteoblastomas showed significantly increased radioactivity on bone scintigraphy,which could be used for postoperative evaluation of spinal osteoblastoma and guiding clinical decision-making.Postoperative bone imaging negative could exclude recurrence of spinal osteoblastoma.