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[局部放射性核素骨扫描固定减低的诊断价值]

[Diagnostic value of localized hypofixations in the radioisotope scanning of bones].

作者信息

Gaucher A, Naoun A, Pourel J, Faure G, Netter P, Colomb J M, Robert J

出版信息

Rev Rhum Mal Osteoartic. 1976 Dec;43(12):715-21.

PMID:1006128
Abstract

The scintigraphic appearances of all localized, evolutive bone lesions, whatever their nature, is usually a "hot spot", that is a zone of hyperfixation of the radioactive material. False negatively scintigraphs are, however, noted: the scintigraphic image appears normal, without a zone of hyperfixation, although radiographs of the skeleton are pathological. The 8 cases presented in this article demonstrate that certain bone lesions (aseptic osteonecrosis and malignant destruction of bone) may sometimes be represented as real zones of hypofixation, as veritable "cold spots". These areas of hypofixation result from either a local interruption in the vascularization, which prevents the isotope from reaching the bony structures, or from a quantitative insufficiency of the bony tissue, this being replaced by neoplastic tissue which, in the cases studied, fixed labelled Bleomycin or iodine-131. These areas of hypofixation and any absences of fixation really are the scintigraphic images of areas of osteolysis or of aseptic osteonecrosis but they are generally masked by hyperfixation around the lesion that results in reactional osteogenesis and hypervascularization.

摘要

所有局限性、进行性骨病变,无论其性质如何,其闪烁扫描表现通常为一个“热点”,即放射性物质高度摄取的区域。然而,也有假阴性的闪烁扫描结果:尽管骨骼的X线片显示为病理性改变,但闪烁扫描图像看起来正常,没有高度摄取区域。本文所呈现的8个病例表明,某些骨病变(无菌性骨坏死和骨恶性破坏)有时可能表现为真正的摄取减低区域,即名副其实的“冷点”。这些摄取减低区域是由于局部血管化中断,阻止了同位素到达骨结构,或者是由于骨组织数量不足,被肿瘤组织替代,在本研究的病例中,肿瘤组织摄取标记的博来霉素或碘 - 131。这些摄取减低区域以及任何无摄取区域实际上是骨溶解或无菌性骨坏死区域的闪烁扫描图像,但它们通常被病变周围的高度摄取所掩盖,这种高度摄取导致反应性骨生成和血管增生。

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