Hori A, Sumiya H, Taki J, Tonami N, Tsuchiya H, Tomita K
Department of Nuclear Medicine and Orthopedics, Kanazawa University School of Medicine, Japan.
Clin Nucl Med. 1997 Nov;22(11):752-5. doi: 10.1097/00003072-199711000-00003.
The authors present a case of bone infarction in the proximal epiphysis of the right tibia, which was caused by preoperative intraarterial chemotherapy for osteosarcoma. MR imaging revealed that suspected metastases had inhomogeneous signal intensity similar to that of the primary tumor, which made a metastatic lesion difficult to exclude. On TI-201 SPECT, no accumulation was found in the lesions, confirming that they were not osseous metastases. Consequently, this enabled limb salvage surgery to be performed with joint preservation. Intraoperative biopsy revealed no viable tumor cells in the lesion, and bone infarction was suspected. TI-201 SPECT was very useful, not only in differentiating bone infarction from tumor progression, including metastatic lesions, but also in the determination of the operative technique.
作者报告了一例右胫骨近端骨骺骨梗死病例，其由骨肉瘤术前动脉内化疗所致。磁共振成像显示，疑似转移灶的信号强度不均匀，与原发肿瘤相似，这使得难以排除转移病变。在TI-201单光子发射计算机断层显像（SPECT）上，病变部位未发现放射性浓聚，证实它们并非骨转移。因此，这使得保肢手术得以在保留关节的情况下进行。术中活检显示病变内无存活肿瘤细胞，怀疑为骨梗死。TI-201 SPECT非常有用，不仅可用于鉴别骨梗死与肿瘤进展（包括转移灶），还可用于确定手术技术。
