Baxter A D, Coakley F V, Finlay D B, West C
Department of Radiology, Leicester Royal Infirmary, UK.
Nucl Med Commun. 1995 Oct;16(10):834-7. doi: 10.1097/00006231-199510000-00006.
The aim of this study was to determine the aetiology of solitary hot spots in the ribs found at bone scintigraphy in patients with known extraskeletal malignancy. A group of 34 patients whose bone scans showed a solitary hot spot in a rib were identified retrospectively over a 4-year period. They all had a known extraskeletal malignancy. Aetiology of the rib hot spot was established in 26 patients based on a review of clinical features, radiographic findings and clinical follow-up. In eight cases it remained indeterminate. In 14 (41%) cases, the rib lesion was malignant in origin, 9 were due to metastasis and 5 due to direct spread from intrapulmonary malignancy. In 12 (35%) cases, it was benign. In the remaining 8 (24%) cases, the aetiology was indeterminate. In the subgroup of 14 hot spots confined to the anterior rib end, 5 (36%) were due to malignancy, 4 (28%) were benign and 5 (36%) were indeterminate. We conclude that solitary hot spots in the ribs of patients with known extraskeletal malignancy undergoing bone scintigraphy are frequently (41%) malignant in origin. This also applies when the hot spot is in the anterior rib end (36% malignant). Thus, such hot spots are far more sinister than previously reported and require careful clinical and radiographic evaluation.
本研究的目的是确定已知骨外恶性肿瘤患者骨闪烁显像时肋骨孤立性热点的病因。回顾性分析了4年间34例骨扫描显示肋骨有孤立性热点的患者。他们均患有已知的骨外恶性肿瘤。通过回顾临床特征、影像学表现和临床随访，确定了26例患者肋骨热点的病因。8例病因仍不明确。14例（41%）肋骨病变起源于恶性肿瘤，9例为转移所致，5例为肺内恶性肿瘤直接蔓延所致。12例（35%）为良性。其余8例（24%）病因不明确。在局限于肋骨前端的14个热点亚组中，5个（36%）为恶性，4个（28%）为良性，5个（36%）病因不明确。我们得出结论，已知骨外恶性肿瘤患者进行骨闪烁显像时，肋骨孤立性热点的起源常为恶性（41%）。当热点位于肋骨前端时也是如此（36%为恶性）。因此，这类热点比以前报道的情况要严重得多，需要仔细的临床和影像学评估。
