白血病患儿的（99m）锝-亚甲基二膦酸盐骨闪烁显像结果：早期和延迟全身显像的价值

(99m)Tc-MDP scintigraphic findings in children with leukemia: value of early and delayed whole-body imaging.

作者信息

Shalaby-Rana E, Majd M

机构信息

Department of Diagnostic Imaging and Radiology, Children's National Medical Center, Washington, DC 20010, USA.

出版信息

J Nucl Med. 2001 Jun;42(6):878-83.

PMID:11390551

Abstract

UNLABELLED

The purpose of this study was to reveal the bone scan abnormalities in children with leukemia and to show the value of whole-body scanning in early and delayed phases.

METHODS

From a database of all patients with a diagnosis of leukemia from January 1990 to April 2000, 12 children (9 male, 3 female; mean age, 8.0 y; age range, 4.7--13.2 y) were identified for whom the diagnosis of leukemia was suggested on the basis of bone scans obtained as part of the initial work-up for unexplained skeletal pain. Early and delayed whole-body bone scans and radiographs were reviewed retrospectively. Areas of abnormal uptake on early and delayed phases were categorized into locations: metaphysis--diaphysis--epiphysis (MDE), pelvis, ribs, spine, and others. MDE lesions included abnormalities in the metaphysis extending into the diaphysis for some length: metaphysis/diaphysis, metaphysis only, diaphysis only, epiphysis only, and the entire bone. Pelvic and spine lesions were further characterized as focal or diffuse.

RESULTS

Ten patients had lesions in 2 or more locations on both phases. Two patients had multiple lesions on the early scans but only rib lesions on the delayed scans. Lesions correlated with symptomatic sites in 8 patients on the delayed scans and in 11 patients on the early scans. The most common sites of abnormalities on the delayed scans were metaphyseal/diaphyseal, pelvis (focal), and ribs. The most common locations of lesions on the early scans were metaphyseal/diaphyseal, pelvis (diffuse or focal), and spine. More metaphyseal/diaphyseal lesions were seen on the early scans than on the delayed scans. Diffuse involvement of the pelvis and spine was seen only on the early phase. However, rib lesions were seen more frequently on the delayed scan.

CONCLUSION

Early whole-body imaging in conjunction with delayed whole-body scanning may enhance the diagnostic accuracy of bone scanning in the evaluation of children with skeletal pain of obscure etiology, such as that associated with leukemia.

摘要

未标注

本研究的目的是揭示白血病患儿的骨扫描异常情况，并展示全身扫描在早期和延迟期的价值。

方法

从1990年1月至2000年4月所有诊断为白血病的患者数据库中，确定了12名儿童（9名男性，3名女性；平均年龄8.0岁；年龄范围4.7 - 13.2岁），他们因不明原因骨骼疼痛的初始检查中进行的骨扫描而被怀疑患有白血病。回顾性分析早期和延迟期的全身骨扫描及X线片。早期和延迟期摄取异常的区域按部位分类：干骺端 - 骨干 - 骨骺（MDE）、骨盆、肋骨、脊柱及其他部位。MDE病变包括干骺端异常延伸至骨干一定长度的情况：干骺端/骨干、仅干骺端、仅骨干、仅骨骺以及整个骨骼。骨盆和脊柱病变进一步分为局灶性或弥漫性。

结果

10例患者在两个阶段的2个或更多部位有病变。2例患者早期扫描有多处病变，但延迟扫描仅有肋骨病变。延迟扫描时有8例患者病变与症状部位相关，早期扫描时有11例患者相关。延迟扫描时最常见的异常部位是干骺端/骨干、骨盆（局灶性）和肋骨。早期扫描时病变最常见的部位是干骺端/骨干、骨盆（弥漫性或局灶性）和脊柱。早期扫描比延迟扫描发现更多的干骺端/骨干病变。仅在早期阶段可见骨盆和脊柱的弥漫性受累。然而，延迟扫描时肋骨病变更常见。