骨样骨瘤全身骨显像和SPECT/CT显像的图像特征分析

目的分析骨样骨瘤全身骨显像(WBS)和SPECT/CT显像的图像特征。方法回顾性纳入2010年1月至2018年12月间西南医科大学附属医院经病理证实且以局部疼痛为主要表现的70例骨样骨瘤患者(男50例,女20例,年龄4~66岁),分析患者99Tcm-亚甲基二膦酸盐(MDP)平面显像及SPECT/CT显像的图像特点。结果WBS联合SPECT/CT显像发现70个病灶,以股骨(37.1%,26/70)和胫骨(35.7%,25/70)病灶多见;56例行三时相骨显像的患者病灶与健侧放射性比值(T/NT)为3.7±1.2。WBS示病灶摄取呈圆形(或类圆形)者48个(68.6%,48/70),呈梭形者21个(30.0%,21/70),不规则形状者1个(1.4%,1/70);SPECT/CT显像示病灶摄取呈圆形(或类圆形)者69个(98.6%,69/70),不规则形状者1个(1.4%,1/70)。WBS中表现为"双灰度征"的病灶有48个(68.6%,48/70);而SPECT/CT显像示59个(84.3%,59/70)病灶表现为"双灰度征"。SPECT/CT显像示59个(84.3%,59/70)病灶有瘤巢,27个(38.6%,27/70)病灶出现钙化或骨化(即"靶征")。结论骨样骨瘤的典型WBS及SPECT/CT显像征象包括"双灰度征"、瘤巢及"靶征"等,这些征象有助于骨样骨瘤的诊断。

Analysis of whole-body bone scintigraphy and SPECT/CT imaging in osteoid osteoma

Objective To analyze features of osteoid osteoma on whole-body bone scan(WBS)and SPECT/CT imaging.Methods From January 2010 to December 2018,70 patients(50 males,20 females,age:4-66 years)with osteoid osteoma confirmed by pathology were enrolled from the Affiliated Hospital of Southwest Medical University.All patients underwent WBS and SPECT/CT imaging and imaging features were retrospectively analyzed.Results A total of 70 lesions were found by WBS combined with SPECT/CT imaging,and 26 lesions(37.1%,26/70)were found in the femur and 25 lesions(35.7%,25/70)in the tibia.The radioactive ratio of target lesion to non-target lesion(T/NT)was 3.7±1.2 in 56 patients who underwent three-phase bone imaging.WBS showed that 48 lesions(68.6%,48/70)were round(or nearly round),21 lesions(30%,21/70)were spindle-shaped,and 1 lesion(1.4%,1/70)was irregular-shaped,while SPECT/CT imaging showed that 69 lesions(98.6%,69/70)were round(or round)and 1 lesion(1.4%,1/70)was irregular-shaped.The"double-density sign"was found in 48 lesions(68.6%,48/70)by WBS and in 59 lesions(84.3%,59/70)by SPECT/CT imaging.SPECT/CT imaging detected nidus in 59 lesions(84.3%,59/70)and calcification or ossification("target sign")in 27 lesions(38.6%,27/70).Conclusion The typical features of osteoid osteoma on WBS and SPECT/CT imaging include"double density sign",nidus and"target sign",which contribute to the diagnosis of osteoid osteoma.