Reuland P, Kaiserling E, Klingebiel T, Feine U, Niethammer D
Abt. Nuklearmedizin, Eberhard-Karls-Universität Tübingen, Deutschland.
Nuklearmedizin. 1999;38(2):38-42.
Influenced by the incorrect diagnosis of a bone metastasis caused by bone necrosis we evaluated reasons and frequency of bone necrosis in patients referred for bone scanning in follow-up of tumors.
Bone scans performed within two years on patients with primary bone tumors or tumors metastatic to bone were reviewed in respect to the final diagnosis bone necrosis.
We found the cases of three young patients who presented the appearance of hot spots on bone scintigrams which were finally diagnosed as bone necrosis. In two cases the diagnosis was based on histological findings, in one case the diagnosis was made evident by follow-up. All the three patients had been treated by chemotherapy and presented no other reason for the development of bone necrosis. Enhanced tracer uptake in all sites decreased within eight weeks up to two years without therapy.
Single and multiple hot spots after chemotherapy may be originated by bone necrosis but mimicry metastases.
受骨坏死导致骨转移误诊的影响，我们评估了在肿瘤随访中接受骨扫描的患者发生骨坏死的原因及频率。
回顾了原发性骨肿瘤或骨转移瘤患者在两年内进行的骨扫描，以确定最终诊断为骨坏死的情况。
我们发现3例年轻患者的骨闪烁显像出现热点表现，最终诊断为骨坏死。2例诊断基于组织学检查结果，1例通过随访确诊。所有3例患者均接受过化疗，且无其他导致骨坏死的原因。未经治疗的情况下，所有部位增强的示踪剂摄取在8周内至两年内均下降。
化疗后出现的单个或多个热点可能源于骨坏死，但会模仿转移瘤。
