Greenspan A, Stadalnik R C
Department of Radiology, University of California, Davis, USA.
Semin Nucl Med. 1997 Oct;27(4):372-85. doi: 10.1016/s0001-2998(97)80010-4.
The introduction of cross-sectional and multiplanar imaging techniques has not diminished the value of radionuclide bone scanning. Skeletal scintigraphy remains an extremely effective and relatively inexpensive tool for diagnosis of many disorders of bones and joints. The sensitivity of scintigraphy in detecting stress fractures approaches 100%, although it is less specific than plain film radiography. However, radionuclide bone scanning can reveal subtle early changes in bone metabolism. For evaluation of infections, particularly in patients with diabetic foot neuropathy, scintigraphy is the modality of choice, although a combination of imaging techniques may be necessary in previously damaged bone. Radionuclide bone scanning has retained its place in the evaluation of primary bone tumors and metastases, and in screening of patients with metabolic bone disease. The radiologist should be aware that although this modality is generally used as an ancillary technique in conjunction with plain radiography, conventional tomography, computed tomography (CT), and magnetic resonance imaging (MRI), at times it can be used as the primary modality not only for the identification of skeletal lesions but also to provide important information required to make a definite diagnosis.
横断面和多平面成像技术的引入并未降低放射性核素骨扫描的价值。骨骼闪烁显像仍然是诊断许多骨骼和关节疾病的极其有效且相对廉价的工具。闪烁显像检测应力性骨折的敏感性接近100%，尽管其特异性不如普通X线摄影。然而，放射性核素骨扫描可以揭示骨代谢的细微早期变化。对于感染的评估，尤其是糖尿病足神经病变患者，闪烁显像是首选的检查方法，尽管对于先前受损的骨骼可能需要联合多种成像技术。放射性核素骨扫描在原发性骨肿瘤和转移瘤的评估以及代谢性骨病患者的筛查中仍占有一席之地。放射科医生应意识到，尽管这种检查方法通常作为辅助技术与普通X线摄影、传统体层摄影、计算机断层扫描（CT）和磁共振成像（MRI）联合使用，但有时它不仅可以作为识别骨骼病变的主要检查方法，还能提供做出明确诊断所需的重要信息。
