Syed Ghulam M, Fielding Henry W, Collier Bert D
Department of Nuclear Medicine, Faculty of Medicine, Kuwait University, PO Box 24923, Safat 13110, Kuwait.
Nucl Med Commun. 2005 Mar;26(3):253-7. doi: 10.1097/00006231-200503000-00010.
When reporting bone scans, it is important to distinguish between normal variants and skeletal pathology involving the sternum. There are only limited reports dealing with age-related normal variants of the sternum on bone scintigraphy.
We have studied the age-related variants of sternal uptake on bone scintigraphy. In a prospective study, 152 consecutive patients (66 males and 86 females) undergoing whole-body bone scanning, and who had no symptoms associated with the sternum, were evaluated for patterns of normal sternal uptake. Three hours after intravenous injection of (99m)Tc-methylene diphosphonate ((99m)Tc-MDP), whole-body bone scans in the anterior and posterior projections were acquired. Patterns of sternal uptake, including the sites and distribution of increased and decreased uptake, were analysed using age-related groups.
Three patterns of tracer uptake in the sternum were recognized: a uniform pattern was most common in children (< or =12 years); a heterogeneous uptake pattern was frequently seen in adolescents, young adult and adult groups; and a segmented pattern was commonly seen in the geriatric group (>60 years). A predominant focal finding was a hot spot at the angle of Louis. In addition, there were focal spots of decreased tracer uptake in the lower sternum, just above the xiphoid process, and spots of increased tracer uptake in the body of the sternum. Such focal spots were not seen in subjects of less than 12 years of age.
Evolutionary changes of the sternum appear to exist throughout life. There are age-related normal variants of sternal uptake on bone scintigraphy.
在报告骨扫描结果时，区分正常变异与涉及胸骨的骨骼病变非常重要。关于骨闪烁显像中与年龄相关的胸骨正常变异的报道非常有限。
我们研究了骨闪烁显像中与年龄相关的胸骨摄取变异情况。在一项前瞻性研究中，对152例连续接受全身骨扫描且无胸骨相关症状的患者（66例男性和86例女性）进行了正常胸骨摄取模式的评估。静脉注射（99m）锝-亚甲基二膦酸盐（（99m）Tc-MDP）3小时后，采集前后位全身骨扫描图像。使用与年龄相关的分组分析胸骨摄取模式，包括摄取增加和减少的部位及分布情况。
胸骨摄取放射性示踪剂的模式有三种：均匀模式在儿童（≤12岁）中最常见；不均匀摄取模式常见于青少年、青年和成年组；节段模式常见于老年组（>60岁）。一个主要的局灶性表现是胸骨角处的热点。此外，在剑突上方的胸骨下部有放射性示踪剂摄取减少的局灶点，在胸骨体部有放射性示踪剂摄取增加的点。在12岁以下的受试者中未见到此类局灶点。
胸骨的演变似乎贯穿一生。骨闪烁显像中存在与年龄相关的胸骨摄取正常变异。
