Pevarski D J, Drane W E, Scarborough M T
Department of Diagnostic Radiology, Shands Hospital, Gainesville, FL, USA.
AJR Am J Roentgenol. 1998 Feb;170(2):319-22. doi: 10.2214/ajr.170.2.9456937.
We prospectively compared the ability of two techniques--bone scintigraphy with single-photon emission computed tomography (SPECT) of the chest and CT of the chest--to reveal potential osteosarcoma metastases of the lung.
Our study included 27 patients with osteosarcoma who prospectively underwent both bone scintigraphy with SPECT of the chest and CT of the chest. The imaging results were compared with outcome or pathologic analysis of any lung lesions found.
Eight (30%) of the 27 patients had pulmonary metastases. Four of these eight patients had positive results on both CT studies and bone SPECT studies, with additional lesions detected with bone SPECT in two of these four patients. The other four patients with pulmonary metastases had positive results on CT studies, whereas the results of bone SPECT studies remained negative. The results of bone SPECT studies were negative in the 19 patients without pulmonary metastases. CT, however, showed abnormalities in seven (37%) of the 19 patients, which were eventually attributed to benign conditions.
Negative results on a bone SPECT study of the chest should not be used to exclude the possibility of lung metastases. However, if the results are positive, a bone SPECT study can be used to confirm abnormalities seen on CT scans and may also reveal subtle lesions missed on CT scans.
我们前瞻性地比较了两种技术——胸部单光子发射计算机断层扫描（SPECT）骨闪烁显像和胸部CT——揭示骨肉瘤潜在肺转移的能力。
我们的研究纳入了27例骨肉瘤患者，他们前瞻性地接受了胸部SPECT骨闪烁显像和胸部CT检查。将影像学结果与发现的任何肺部病变的结果或病理分析进行比较。
27例患者中有8例（30%）发生肺转移。这8例患者中有4例在CT检查和骨SPECT检查中结果均为阳性，这4例患者中有2例通过骨SPECT检测到了额外的病变。其他4例肺转移患者CT检查结果为阳性，而骨SPECT检查结果仍为阴性。19例无肺转移患者的骨SPECT检查结果为阴性。然而，CT显示这19例患者中有7例（37%）存在异常，最终归因于良性情况。
胸部骨SPECT检查结果为阴性不应被用于排除肺转移的可能性。然而，如果结果为阳性，骨SPECT检查可用于确认CT扫描中发现的异常，也可能揭示CT扫描遗漏的细微病变。
