Bushnell D L, Kahn D, Huston B, Bevering C G
Iowa City VA Medical Center, Nuclear Medicine Service, IA 52246, USA.
Skeletal Radiol. 1995 Jan;24(1):13-6. doi: 10.1007/BF02425938.
Determining the etiology of a focal lesion seen on bone scan in patients with primary tumors usually requires the use of other imaging procedures or biopsy. Single positron emission computed tomography (SPECT) with high resolution multidetector systems can localize the specific site of a vertebral lesion and in this way potentially differentiate between benign and metastatic disease. SPECT images of the lower thoracic and lumbar spine were reviewed for lesion location and intensity by two experienced interpreters. Follow-up data were adequate to ascertain the cause of 71 lesions seen on SPECT in 29 patients. Twenty-six of these lesions were not seen on planar images. Of the 71 lesions, 44 were benign and 27 metastatic. Of the 15 lesions where the pedicle was involved, 11 were found to metastatic. There were a total of 14 facet lesions, 9 of which were present in vertebra with no lesions at sites other than the facets. All 9 of these isolated facet lesions turned out to be benign. Lesion intensity did not distinguish benign from malignant disease. We conclude that SPECT imaging is useful in determining the etiology of focal lesions seen on bone scan in patients with a known primary tumor referred for evaluation of metastatic disease.
确定原发性肿瘤患者骨扫描中发现的局灶性病变的病因通常需要使用其他成像检查或活检。采用高分辨率多探测器系统的单光子发射计算机断层扫描（SPECT）能够定位椎体病变的具体部位，从而有可能区分良性疾病和转移性疾病。两名经验丰富的解读人员对下胸椎和腰椎的SPECT图像进行了病变位置和强度的评估。随访数据足以确定29例患者SPECT上所见71处病变的病因。其中26处病变在平面图像上未显示。在这71处病变中，44处为良性，27处为转移性。在15处累及椎弓根的病变中，11处为转移性。共有14处小关节病变，其中9处位于除小关节外其他部位无病变的椎体。所有这9处孤立的小关节病变均为良性。病变强度无法区分良性和恶性疾病。我们得出结论，SPECT成像有助于确定因怀疑转移性疾病而转诊的已知原发性肿瘤患者骨扫描中所见局灶性病变的病因。
