Ongseng F, Goldfarb C R, Finestone H
Department of Radiology, Beth Israel Medical Center, New York, New York 10003, USA.
J Nucl Med. 1995 Oct;36(10):1797-9.
We sought to determine the frequency and significance of axillary lymph node visualization on bone scans performed with diphosphonates.
Consecutive 99mTc-methylene diphosphonate (99mTc-MDP) bone scans (2435) were inspected for axillary soft-tissue uptake. In positive cases, the results of physical examination, correlative imaging studies and serial bone scans were recorded, as was the site of venipuncture.
Forty-eight studies (2%) showed axillary uptake ipsilateral to the injection site. Extravasation of tracer, documented by focal activity near the injection site, was present in every case. There was no association with axillary adenopathy, mass, induration or radiographically visible calcification. On some images, foci adjacent to the axilla were superimposed on the rib, scapula, or humerus. The bone-to-background ratio was frequently reduced; repeat imaging after 1-2 hr usually improved osseous detail.
Ipsilateral axillary lymph node visualization due to extravasation of 99mTc-MDP is frequently associated with additional foci superimposed on osseous structures simulating pathology. Delayed skeletal uptake is common in such cases and necessitates a greater time interval between injection and imaging.
我们试图确定使用二膦酸盐进行骨扫描时腋窝淋巴结显影的频率及意义。
对连续的2435例99m锝-亚甲基二膦酸盐（99mTc-MDP）骨扫描进行腋窝软组织摄取情况检查。对于阳性病例，记录体格检查结果、相关影像学检查及系列骨扫描结果，以及静脉穿刺部位。
48项研究（2%）显示注射部位同侧腋窝有摄取。所有病例均存在注射部位附近局灶性放射性浓聚所证实的示踪剂外渗。与腋窝淋巴结病、肿块、硬结或影像学可见的钙化无关。在一些图像上，腋窝附近的病灶叠加在肋骨、肩胛骨或肱骨上。骨与本底比值常降低；1 - 2小时后重复成像通常可改善骨质细节。
99mTc-MDP外渗导致的同侧腋窝淋巴结显影常与叠加在骨质结构上模拟病变的其他病灶相关。在这种情况下，骨骼摄取延迟很常见，需要在注射与成像之间留出更长的时间间隔。
