SPECT/CT骨显像在钙化防御诊断中的应用价值-东南大学学报医学版

SPECT/CT骨显像在钙化防御诊断中的应用价值

单位：1. 南京大学医学院, 江苏南京 210046;
2. 东南大学附属中大医院核医学科, 江苏南京 210009;
3. 东部战区总医院核医学科, 江苏南京 210002

关键词：钙化防御 ^99m锝-亚甲基二膦酸盐单光子发射型计算机断层扫描骨显像骨外摄取

分类号：R543;R445.6

出版年·卷·期（页码）：2021·40·第二期（202-206）

摘要：

目的：探讨^99m锝-亚甲基二膦酸盐（^99mTc-MDP）单光子发射型断层扫描/X线计算机断层扫描（SPECT/CT）骨显像在钙化防御中的诊断价值。方法：回顾性分析东南大学附属中大医院2017年11月至2020年5月临床病理确诊为钙化防御的17例患者的^99mTc-MDP SPECT/CT骨显像检查资料，根据患者临床资料及^99mTc-MDP SPECT/CT骨显像结果分析其临床特点及影像学表现。结果：17例钙化防御患者16例出现骨外异常摄取^99mTc-MDP，阳性率为94.1%，仅1例SPECT/CT显像无阳性表现，阴性率为5.9%。部分患者表现为多脏器的累及，其中累及躯干、四肢皮肤8例，占总病例的47.1%，表现为病变处皮肤增厚，皮下可见软组织团块、结节、钙化、炎性渗出等，病变区域放射性摄取不同程度增高。多器官受累5例，占总病例的29.4%，表现为皮肤及皮下组织、骨骼肌、心肌、肺放射性异常增高，其中1例患者经硫代硫酸钠治疗后，临床表现及SPECT/CT骨显像表现均明显减轻。另累及阴茎1例。结论：钙化防御患者^99mTc-MDP SPECT/CT骨显像有其特定的影像学表现，SPECT/CT骨显像对于钙化防御患者有重要的诊断价值。

Objective: To investigate the value of ^99mTechnetium-methylene diphosphonate (^99mTc-MDP)single photon emission computed tomography/computed tomography(SPECT/CT) bone imaging in the diagnosis of calciphylaxis. Methods: The data of ^99mTc-MDP SPECT/CT bone imaging of 17 patients with calciphylaxis confirmed by pathology in Zhongda Hospital of Southeast University from November 2017 to May 2020 were retrospectively analyzed. According to the clinical data and ^99mTc-MDP SPECT/CT bone imaging results, the imaging manifestations and clinical characteristics were analyzed. Results: 16 of the 17 patients with calciphylaxis had extraosseous uptake at the lesion site, the positive rate was 94.1%, only 1 patient had no positive manifestation on SPECT/CT, and the negative rate was 5.9%. Some of the patients showed involvement of multiple organs, including 8 cases involving the skin of trunk and limbs, accounting for 47.1% of the total cases, presenting thickening of the skin at the lesion site, subcutaneous soft tissue masses, nodules, calcification and inflammatory exudation, etc. The radiation uptake in the lesion area increased to varying degrees. There were 5 cases with multiple organ involvement, accounting for 29.4% of the total cases, showing abnormal increase of radioactivity in skin and subcutaneous tissues, skeletal muscle, heart muscle and lung. The clinical manifestations and SPECT/CT bone imaging were significantly reduced in 1 patient treated with sodium thiosulfate. The penis was involved in another case. Conclusion: ^99mTc-MDP SPECT/CT bone imaging has its special features in patients with calciphylaxis, which can provide important diagnostic value for patients with calciphylaxis.

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