Shih W J, Li C Y, Coffey C W, Maruyama Y
Nuclear Medicine Division, Veterans Administration Medical Center, Lexington, Kentucky.
Radiat Med. 1989 Jan-Feb;7(1):32-5.
We present a patient with unresectable bronchogenic carcinoma who underwent irradiation, then had four consecutive bone imaging studies in a 26-month period. Apparent photopenia of the upper thoracic vertebrae developed within six months after irradiation and became more apparent in the images thereafter. At autopsy a section of the corresponding bone marrow showed extensive fatty changes with very few residual blood vessels. Radiation damage of the vascular networks may significantly reduce the blood supply, when integrity of the blood supply is essential for delivery of a normal bone image by the bone-imaging agent. Interruption of blood supply may cause photopenia, and this interruption plus irradiation to marrow elements may also affect the hematopoietic activity of the corresponding bone marrow. The occurrence of radiation-induced photopenia on a bone-imaging study may indicate fatty changes of the corresponding marrow.
我们报告一例不可切除的支气管源性癌患者，该患者接受了放射治疗，然后在26个月内连续进行了4次骨显像研究。照射后6个月内出现上胸椎明显的放射性减低，此后在图像上更加明显。尸检时，相应骨髓切片显示广泛的脂肪变性，残留血管极少。当骨显像剂传递正常骨图像的血供完整性至关重要时，血管网络的放射损伤可能会显著减少血供。血供中断可能导致放射性减低，这种中断加上对骨髓成分的照射也可能影响相应骨髓的造血活性。骨显像研究中出现放射性诱导的放射性减低可能提示相应骨髓的脂肪变性。
