摘要目的 分析多骨型骨纤维异常增殖症(PFD)99Tcm-亚甲基二膦酸盐(MDP)平面显像与SPECT/CT显像的图像特征.方法 回顾性纳入2007年6月至2017年3月间23例PFD患者,其中男12例,女11例,年龄10～77(31.4±3.4)岁.23例中21例经病理确诊,2例经临床和全身骨显像随访证实.分析患者99 Tcm-MDP全身骨平面显像和SPECT/CT显像的图像特点.结果 全身平面显像示患者四肢骨受累最常见,下肢和右侧肢体较上肢和左侧肢体的病灶多.23例PFD中78.3％(18/23)的患者其病灶呈一侧或以一侧分布为主,16例有四肢骨病灶的患者中15例(93.8％)四肢骨未见骨骼变形,而颅骨、肋骨和骨盆膨大和畸形多见;椎体和手足骨受累的患者分别占30.4％(7/23)和26.1％(6/23);96.9％(248/256)的病灶呈中、高度放射性摄取增高,在四肢、肋骨和颅骨呈条形分布.SPECT/CT显像示磨玻璃样密度、"丝瓜络"样改变和混合病变放射性摄取程度高于囊性透亮区.结论PFD的全身骨显像具有特征性,SPECT/CT显像可反映PFD病灶的病理、血流和代谢改变.

abstractsObjective To analyze the image characteristics of whole-body bone planar scan and SPECT/CT imaging in patients with polyostotic bone fibrous dysplasia ( PFD) . Methods Twenty-three pa-tients with PFD (12 males, 11 females, age: 10-77(31.4±3.4) years) between June 2007 and March 2017 were enrolled. Twenty-one patients were confirmed pathologically and 2 was diagnosed by follow-up re-sults. The images of 99Tcm-methylene diphosphonate (MDP) whole-body bone scan and SPECT/CT imaging were retrospectively analyzed. Results Bone involvement in the extremities was the most common and lesions in the lower and right limbs were more than those in the upper and left limbs. Lesions were frequently unilat-erally on whole-body bone planar images in 18 of the other 23 patients ( 78. 3％) . Among them, 15/16 with limb lesions showed no bone deformation in limbs, while the enlargement and deformity were more common in the skull, ribs and pelvis. Vertebral involvement was found in 7 of 23 patients (30.4％), and the hand and foot bone involvement was found in 6 of 23 patients (26.1％). Most lesions (96.9％, 248/256) presented high or mod-erate abnormal uptake, which distributed in a stripe shape in the extremities, ribs and skull. On SPECT/CT ima-ges, the ground glass, vegetable sponge and mixed lesions showed higher uptake compared with the cystic le-sions. Conclusions The PFD has certain characteristics on whole-body bone scan. SPECT/CT imaging can reflect pathological, blood flow and metabolic changes of PFD.