骨嗜酸性肉芽肿核素骨显像与X线特征对比分析

【目的】研究骨嗜酸性肉芽肿患者的核素全身骨显像表现特征，探讨骨显像在诊断和疗效观察中的应用价值。【方法】回顾性分析49例经病理证实的骨嗜酸性肉芽肿患者的核素全身骨显像表现特征，并与X线摄片结果对比观察，11例患者在治疗后复查全身骨显像对疗效及病情进展进行动态监测。【结果]49例患者中，骨显像发现单发病灶27例（55．1％），多发病灶22例（44．9％），骨显像共发现病灶132处。在22例多发病灶患者中，骨显像发现105处病灶，其中32例X线检查未发现异常；而X线共发现病灶78处，其中5处骨显像表现为阴性。两者相比，骨显像较X线检查能够发现更多的病灶，差异具有统计学意义（x2=23．686，P〈0．01）。11例患者治疗后复查了骨显像，8例单发病灶患者手术效果良好，1例单发及2例多发病灶患者出现新的病灶。【结论】骨嗜酸性肉芽肿在核素全身骨显像上具有一定特征性表现，骨显像对多发病灶的探测能力优于X线，可作为治疗过程中疗效监测的常规手段。

Comparative Analysis of the Characteristics of Radionuclide Bone Scan vs X-ray in EosinophilicGranuloma of Bone

Objective] To study the features of eosinophilic granuloma of bone（EGB） on radionuclide bone scan and explore the value of bone scan in the diagnosis and treatment monitoring. Methods] The features of whole body＇bone scan in 49 EGB patients confirmed pathology were analyzed retrospectively. The results were contrastively analyzed with X-ray. Whole body bone scan of 11 patients were performed again after treatment so as to monitor the efficacy and progression dynamically. Results] In 49 patients, bone scan showed that 27 patients（55.1%） had single lesion and 22 patients（44.9%） had multiple lesions. Bone scan detected 132 le- sions. In 22 patients with multiple lesions, bone scan detected 105 lesions, in which 32 lesions were not detec- ted by X-ray. On the other hand, X-ray examination detected 78 lesions in these 22 patients, in which 5 lesions had no abnormality on bone scan. Bone scan could discover more lesions than X-ray examination, and there was significant difference（x2 =23. 686, P 〈0.01）. Eleven patients underwent follow-up bone scan. Eight pa- tients with single lesion showed fine result after surgery, and another one with single lesion and 2 patients with multiple lesions showed new focus presence. Conclusion] Eosinophilic granuloma of bone has a certain char- acteristic findings on radionuclide bone scan. The detecting ability of bone scan is better than X-ray for multi- ple lesions. Bone scan may be act as a routine tool for the efficacy monitoring during treatment.