Hermann G, Goldblatt J, Levy R N, Goldsmith S J, Desnick R J, Grabowski G A
AJR Am J Roentgenol. 1986 Nov;147(5):943-8. doi: 10.2214/ajr.147.5.943.
The effectiveness of CT and technetium-99m sulfur colloid (99mTc SC) bone-marrow scans in determining the extent and severity of skeletal involvement in 23 patients with type 1 Gaucher's disease was compared with the effectiveness of conventional radiographic techniques and technetium-99m methylene diphosphonate (99mTc MDP) bone scintigrams. Density measurements obtained by CT proved sensitive in differentiating normal marrow (-50 to -120 H). Scintigrams with the sulfur colloid nuclide demonstrated three distinct patterns of uptake: peripheral expansion of normal marrow (profile B), greater marrow expansion with patchy areas lacking uptake (profile C), and greater loss of uptake with retention of the nuclide in other reticuloendothelial organs and circulation (profile D). CT scans provided greater sensitivity in resolving the extent of marrow involvement in affected areas, while the 99mTc SC scintigrams were more effective in overall assessment of the severity of bone-marrow involvement. Both conventional radiographic techniques and 99mTc MDP bone scans were useful primarily as screening procedures or for evaluating specific involved areas. 99mTc MDP scans were useful in evaluating regional defects (i.e., ischemic necrosis) in certain cases, but no consistent patterns were observed. CT and 99mTc SC scans are useful for determining the extent and severity of Gaucher's disease involvement of bone marrow.
对23例1型戈谢病患者，比较了CT和锝-99m硫胶体（99mTc SC）骨髓扫描在确定骨骼受累范围和严重程度方面的有效性，并与传统放射学技术和锝-99m亚甲基二膦酸盐（99mTc MDP）骨扫描的有效性进行了比较。CT获得的密度测量结果被证明对区分正常骨髓（-50至-120 H）很敏感。硫胶体核素的扫描显示出三种不同的摄取模式：正常骨髓的外周扩张（B型）、骨髓扩张更明显且有摄取缺失的斑片状区域（C型）以及摄取丧失更严重且核素保留在其他网状内皮器官和循环中的情况（D型）。CT扫描在确定受累区域骨髓受累范围方面具有更高的敏感性，而99mTc SC扫描在全面评估骨髓受累严重程度方面更有效。传统放射学技术和99mTc MDP骨扫描主要作为筛查程序或用于评估特定受累区域。99mTc MDP扫描在某些情况下对评估区域缺损（即缺血性坏死）有用，但未观察到一致的模式。CT和99mTc SC扫描有助于确定戈谢病骨髓受累的范围和严重程度。
