99Tcm-MDP骨显像时正常和异常的骨外放射性聚集

Normal and Abnormal Extraosseous Uptake of 99Tcm-MDP on Bone Scintigraphy

  • 摘要:99Tcm-MDP骨显像中,正常可见的骨外软组织结构是肾、输尿管、膀胱和乳腺。当骨显像上出现异常的软组织活性时,首先要排除人为因素和示踪剂质量问题。加强示踪剂的质量控制,规范骨显像的操作技术是减少和避免技术伪像的重要途径。由患者自身的病理学因素所致软组织和脏器对骨显像剂的异常聚集更多地与恶性病变有关。肝、肺和乳腺恶性肿瘤是骨显像上显示有软组织聚集的最常见的病理学原因,其他肿瘤也偶尔可见。体腔内弥漫性异常活性则可能与恶性的胸膜损伤及胸水、腹水有关。非骨的示踪剂摄取也可以在一些良性肿瘤、肿脓、炎症、创伤、钙化灶、辐射损伤和淀粉样变的良性病变中见到。异常的软组织示踪剂聚集常常可以提供有用的信息,在读片时应结合临床,仔细辨别。

     

    Abstract: The kidney, ureter, bladder and mammary gland are the extraosseous soft tissues that are normally visible on bone scintigraphy. If abnormal soft tissue activities are observed on bone scintigraphy, the possibility that such abnormal activities are caused by the human factor or the quality problem of the skeletal imaging agent should first be precluded. Enhancing the quality control of the skeletal imaging agent and specificating the technical procedure of bone scintigraphy are the important means for reducing and avoiding technical artifacts. If an abnormal concentration of the skeletal imaging agent in soft tissues and organs is caused by the pathologic factor of a patient himself, it may be concerned with a malignant disease in most cases. The malignant tumor of liver, lung and mammary gland is the most frequent pathologic reason for soft tissue accumulation on bone scintigraphy. However, soft tissue accumulation can also be seen in other tumors occasionally. On the other hand, the diffuse abnormal activity in intracavity may be concerned with malignant injury in the pleura of chest and abdomen, and pleural and ascitic fluids. Extraosseous tracer uptake can also be found in benign lesions such as benign tumor, pus, inflammation, wounds, calcification, radiation damage and amyloidosis. Because the abnormal tracer agent concentration in the soft tissue can often provide valuable clinical information, the film must be read with care in conjunction with clinical data and other examinations.

     

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