Wallis J W, Fisher S, Wahl R L
Division of Nuclear Medicine, Mallinckrodt Institute of Radiology, Washington University Medical Centre, Seattle.
Nucl Med Commun. 1987 May;8(5):357-63. doi: 10.1097/00006231-198705000-00006.
Uptake of bone scanning agents in non-osseous sites has been described in a variety of pathologic conditions including tumor metastases. We have seen several patients in which such uptake was proximal and ipsilateral to the injection site of 99Tcm-methylene diphosphonate, apparently in normal lymph nodes. To further investigate this phenomenon, it was studied in a rat model. Activity in popliteal nodes ipsilateral to the injection site was over 60-fold greater in the animals that received subcutaneous (s.q.) footpad injection compared to femoral IV injection. Ipsilateral popliteal node activity in the s.q. group was 159 times that of contralateral popliteal nodes, with an ipsilateral node to liver ratio of 184:1. In summary, dramatically increased uptake of 99Tcm-MDP in normal lymph nodes ipsilateral and proximal to an extravasated injection has been demonstrated. An awareness of this phenomenon in the clinical setting can avoid confusion with pathologic forms of soft tissue uptake.
在包括肿瘤转移在内的多种病理状况下，已观察到骨扫描剂在非骨部位的摄取。我们见过几例患者，其摄取发生在99锝-亚甲基二膦酸盐注射部位的近端和同侧，明显位于正常淋巴结。为进一步研究这一现象，我们在大鼠模型中进行了研究。与经股静脉注射相比，接受皮下（sq）足垫注射的动物，注射部位同侧腘窝淋巴结的活性高出60倍以上。皮下注射组同侧腘窝淋巴结活性是对侧腘窝淋巴结的159倍，同侧淋巴结与肝脏的比值为184:1。总之，已证实在外渗注射部位同侧和近端的正常淋巴结中，99锝-亚甲基二膦酸盐的摄取显著增加。在临床环境中认识到这一现象可避免与软组织摄取的病理形式相混淆。
