关键词: 原发性肥大性骨关节病;肿瘤;99 Tc m -MDP;放射核素显像

    摘 要:目的 评价继发性肥大性骨关节病(HOA)放射性核素显像的特点与鉴别. 方法 放射性核素99 Tcm -MDP全身骨显像结合临床表现，对继发性HOA的肿瘤患者55例进行了核素闪烁显像分析.参照Ali分级方法，观察了四肢骨、肩胛骨、锁骨、颅骨、肋骨、骨盆及骨关节的放射性分布和摄取强度.同时对11例患者进行了疗效的影像学随访观察. 结果 55例患者的四肢长管骨均有“双条征”表现，48例(87%)下肢骨的放射性聚集活度较上肢明显，46例(84%)伴有对称、规律性骨皮质放射性增加，49例(89%)呈均匀态的累及，31例患者有对称性关节周围放射性浓集的增加.疗效观察11例患者有6例随原发病灶的去除HOA影像特征及临床表现得到明显改善或消失，2例呈波动性，1例无变化，2例影像学及症状、体征加重. 结论 “双条征”为HOA主要影像学改变.HOA的放射性核素影像特征易与骨转移瘤等相鉴别.HOA的影像随访观察有助于疗效、病情发展及预后的评估.

    Imaging observation of secondary hypertrophic os┐teoarthropathy by 99 Tcm ┐methylene diphosphonate bone scans

    XU Hai-Feng，ZHANG Wang-Feng，ZHOU Run-Suo，MU Ji-Zhen

    Department of Nuclear Medicine，Tangdu Hospital，Fourth Military Medical Univerisity，Xi'an710038，China

    Keywords:osteoarthropathy，primary hypertrophic;tumor;99 Tcm -MDP;radionuclide imaging

    Abstract:AIM To evaluate the characteristic findings of the secondary hypertrophic osteoarthropathy(or called hyper-trophic pulmonary osteoarthropathy，HPO)and differentiate the bone metastases or some osteoarthropathy diseases from HPO.METHODS Fifty-five tumor cases were confirmed on HPO with 99 Tc m -MDP the whole body bone scintigraphy com-bined X-ray imaging and clinical manifestation.It was ob-served to grading scale and distribution of radionuclide in ex-tremities ......