99Tc^m-MDP骨显像评估脊柱骨样骨瘤及成骨细胞瘤射频消融效果

目的探讨99Tcm-亚甲基二磷酸盐骨显像对脊柱骨样骨瘤和成骨细胞瘤射频消融疗效评估的价值。资料与方法回顾性收集行射频消融的7例脊柱骨样骨瘤及成骨细胞瘤患者的影像学及临床资料,分析骨显像、CT表现与患者症状、随访结果的关系。结果7例患者(其中骨样骨瘤4例,成骨细胞瘤3例)接受8次射频消融。治疗后2例无疼痛复发,第3、6个月骨显像呈轻度浓聚,其中1例第3个月CT示病变缩小,第12个月消失。3例第4~5个月疼痛复发,骨显像呈轻度浓聚1例,显著浓聚2例,同期CT示病变较治疗前均无变化,继续随访患者疼痛消失。2例射频消融后仍有间断轻度疼痛,第9、12个月骨显像均呈显著浓聚,同期CT示病变缩小1例,增大1例,患者后续分别行手术和再次射频消融。结论骨显像能够早期判断骨样骨瘤和成骨细胞瘤射频消融后病变的活性。骨显像轻度浓聚预示病变治愈,显著浓聚提示病变尚存活性,需继续随访。

99Tc^m-MDP Bone Scan in Evaluating the Effect of Radiofrequency Ablation for Spinal Osteoid Osteoma and Osteoblastoma

Purpose To explore the value of 99Tcm-methylene diphosphonate bone scan in evaluating the efficacy of radiofrequency ablation for osteoid osteoma and osteoblastoma of the spine.Materials and Methods The imaging and clinical data of seven patients with spinal osteoid osteoma and osteoblastoma who underwent radiofrequency ablation were retrospectively collected.The features of bone scan and CT were recorded.The relationship between imaging features and the clinical results were analyzed.Results Seven patients(4 osteoid osteomas,3 osteoblastomas)underwent eight radiofrequency ablations.After treatment,two patients were free of pain on the 3rd and 6th months follow-up visit.Both lesions showed slight concentration on bone scan and one lesion shrank on the 3rd month CT and disappeared on the 12th month CT.Three patients had pain recurrence on the 4th to 5th months follow-up but disappeared thereafter.One lesion showed slight and two lesions had avid concentration on bone scan,while the CT findings of these lesions were similar with the pretreatment CT.Two patients still suffered from intermittent mild pain after ablation.Both lesions showed avid concentration on the 9th and 12th months follow up.One lesion reduced but the other increased on CT.The patients underwent resection and second radiofrequency ablation respectively.Conclusion Bone scan can evaluate the activity of osteoid osteoma and osteoblastoma after radiofrequency ablation at an early stage and is helpful to guide clinical decision-making.Slight radioactivity on bone scan indicates healing of the lesion,while avid concentration suggests that the lesion is still alive and needs follow-up.