骨纤维结构不良的SPECT/CT骨显像及临床特点

  目的   分析骨纤维结构不良的SPECT/CT骨显像结果，探讨其核医学显像特征及鉴别要点。   方法   回顾性分析我院34例经病理或随诊证实为骨纤维结构不良患者的SPECT/CT影像学特点，按病灶数量分为单发骨纤维结构不良病灶组(n=25)及多发病灶组(n=9)，比较两组患者的临床资料、病灶特点及放射性分布特点。   结果   34例病例中，20例有疼痛症状(58.8%)，但两组差异无统计学意义(χ2=1.045，P=0.307)。多病灶组年龄较单病灶组小(t=17.315，P=0.018)；两组血清白细胞水平、中性粒细胞水平、C反应蛋白、碱性磷酸酶及肿瘤指标(癌胚抗原、甲胎蛋白、CA199、CA724、CYFRA21-1、神经元特异性烯醇化酶、胃泌素释放肽前体)的差异均无统计学意义(P>0.05)。病变多见于四肢长骨，病变类型以磨玻璃样及囊状改变多见，多病灶型出现磨玻璃样改变的概率较大(χ2=8.579，P=0.003)，而丝瓜络样、地图样及囊状改变等征象在两组间出现频率的差异无统计学意义(P> 0.05)；34例全部病灶均为放射性异常浓聚，多病灶型常见集中于一侧的放射性浓聚优势灶。   结论   SPECT/CT可通过一次全身成像，观察全身骨多部位病灶，分析各病灶的解剖结构及代谢状态，可作为骨纤维结构不良的鉴别与诊断的重要补充检查方法。 

SPECT/CT bone imaging and clinical features of osteofibrous dysplasia

  Objective   To explore the imaging characteristics and clinical features of whole-body SPECT/CT for bone scintigraphy in patients with osteofibrous dysplasia.   Methods   The characteristics of SPECT/CT imaging were analyzed retrospectively in 34 patients with osteofibrous dysplasia. According to the number of lesions, the cases were divided into multi-lesion group(n=25)and single-lesion group(n=9). The indicators of two groups were compared.   Results   The symptom of pain was present in 20 cases (58.8%). The difference between the two groups was not significant (χ2=1.045, P=0.307). The age of the multi-lesion group was younger than that of the single-lesion group(t=17.315, P=0.018). The serum WBC levels, neutrophil levels, C-reactive protein, alkaline phosphatase and all the tumor markers (CEA, AFP, CA199, CA724, CYFRA21-1, NSE, ProGRP) had no statistically significant differences between two groups (P>0.05). The lesions were more common in the long bones of extremities, which showed ground glass and cystic changes. The probability of ground glass changes was higher in the multi-lesion group (χ2=8.579, P=0.003), while no significant difference in loofah, map, and cystic changes between the two groups (P>0.05). The SPECT imaging showed all the lesions in the thirty-four patients by high uptake of radiotracer, especially when focusing on one limb in polyostotic osteofibrous dysplasia.   Conclusion   Bone scintigraphy with SPECT/CT can be used as an important supplementary examination method for the differentiation and diagnosis of fibrous dysplasia by observing multiple bone lesions in the whole body, analyzing the anatomical structure and metabolic status of each lesion through one-time whole-body imaging.