中国实用儿科杂志

中国实用儿科杂志

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核素骨扫描在神经母细胞瘤诊断和疗效评价中的应用

杨光a,唐锁勤a,王建文a,丁勇b,姚树林b,刘英a,冯晨a   

  1. 中国人民解放军总院 a小儿内科 b核医学科，北京100853
  • 收稿日期:2006-09-12 修回日期:2006-11-18 出版日期:2007-03-06 发布日期:2007-03-06

The significance of radionuclide bone scan in the diagnosis and therapeutic response evaluation of neuroblastoma.

YANG Guang,TANG Suoqin,WANG Jianwen,et al.   

  1. Department of Pediatrics,the General Hospital of PLA,Beijing 100853,China
  • Received:2006-09-12 Revised:2006-11-18 Online:2007-03-06 Published:2007-03-06

摘要： 目的探讨核素骨扫描在儿童神经母细胞瘤(NB)临床分期和疗效评价中的应用价值。 方法200101—200509对解放军总医院小儿内科住院的NB患儿36例，在系统治疗前均行99mTc亚甲基二磷酸盐(99mTcMDP)全身骨扫描；其中13例骨扫描阳性患儿在治疗及随访过程中行2~4次全身骨扫描，观察骨转移的消退情况，一般在5~6疗程诱导化疗后复查；6例行自体外周血干细胞移植的患儿在移植前、后分别复查骨扫描。 结果36例患儿中骨扫描阳性23例(63.9%)，四肢长骨、脊柱、颅骨、骨盆、肋骨、肩胛骨受累分别为15,12,9,6,5和1例次，其中18例表现为多发阳性灶(78.3%)。13例随访患儿中，其中8例经5~6疗程诱导化疗后骨扫描异常浓聚灶范围缩小、浓聚程度减轻，表明病灶修复，治疗有效；5例患儿放射性浓聚灶无变化或增加，表明病情无变化或进展，治疗无效。 结论核素骨扫描为NB诊断及临床分期提供更准确的信息，并有助于疗效评价和预后判断。

关键词: 神经母细胞瘤, 儿童, 骨, 放射性核素显像

Abstract: AbstractObjectiveTo evaluate the significance of bone scan in the clinical staging and evaluation of therapeutic effect of neuroblastoma. MethodsWhole body 99m Technetium methylene diphosphonate ( 99mTcMDP) bone scan was performed on all 36 children with neuroblastoma before the systemic treatments.Thirteen out of 36 patients received 2~4 bone scans during the process of chemotherapy and followup,including 6 patients who rechecked the bone scans pre and postautologous peripheral blood stem cell transplantation. ResultsTwentythree of 36 cases (63.9%) were positive for bone scan.The extremities,spine,skull,pelvis,rib and scapula involvements were 15,12,9,6,5 and 1,respectively.Multiple focus was seen in 18 patients (78.3%).Among 13 patients during followup,the abnormal density became weaken in 8 patients,and unchanged in 5 patients. ConclusionThe radionuclide bone scan is simple,safe,atraumatic and repeatable.Bone scanning is valuable in the diagnosis and clinical staging of neuroblastoma,and useful for the evaluation of therapeutic effect as well as the judgement of prognosis.It is a valuable clinical examination for neuroblastoma.

Key words: Bone, Radionuclide scintigraphy , Child