目的：探讨软组织肿瘤异常摄取骨显像剂99m锝⁃亚甲基二膦酸盐（99mTc⁃MDP）的临床意义。方法自2009年5月－2014年12月，6350例患者行SPECT骨显像，共发现29例32处软组织肿瘤异常摄取99mTc⁃MDP，其中13例经病理确诊，另16例经CT（ n＝8）、MR（ n＝5）和PET／CT（ n＝3）予以证实。测量软组织肿瘤大小，对其摄取显像剂程度进行分级，并分析摄取程度在原发和转移病灶之间的差别。结果32处异常摄取99mTc⁃MDP 的肿瘤长径中位数为5�9（3�0～20�0）cm；其中原发性恶性肿瘤15处，转移性肿瘤17处，原发性肿瘤摄取Ⅱ级为14处，1处为Ⅲ级摄取；转移性恶性肿瘤异常摄取Ⅱ级为11处，Ⅲ级异常摄取者5处，Ⅳ级异常摄取1处。原发性肿瘤与继发性肿瘤在低、高级别异常摄取骨显像剂方面差异无统计学意义（P＞0�05）。结论部分体积较大的原发性和转移性肿瘤摄取骨显像剂99m Tc⁃MDP的摄取水平多为Ⅱ～Ⅲ级；全身骨显像时发现软组织异常骨显像剂摄取时，应高度怀疑恶性肿瘤的可能。%Objective To evaluate the clinical significance of abnormal soft tissue tumor uptake of bone tracer( 99m Tc⁃methyl⁃ene diphosphonic acid, 99mTc⁃MDP). Methods From May 2009 to Dec 2014, radionuclide imaging(wholebody bone scan) was per⁃formed in 6350 patients with malignancy in our department,and 32 soft tissue tumor uptake of 99m Tc⁃MDP was found in 29 patients. The final diagnosis was obtained from pathology ( n=13) , typical imaging findings ( CT=8, MR=5 and PET/CT=3, respectively) . The maximal diameter of lesions were measured, the uptake level was graded and their difference between primary and metastatic lesions were analyzed. Results The median diameter of 32 soft tissue lesions diagnosed as uptake 99mTc⁃MDP was 5.9 (3.0-20.0 cm). There were 15 primary tumor ( gradeⅡ=14, grade Ⅲ=1) and 17 metastatic tumors( gradeⅡ=11, grade Ⅲ=5, gradeⅣ=1 ) . There was no statistical differences in low ( gradeⅡ) and high ( gradeⅢandⅣ) level uptake between primary and metastatic tumor ( P>0.05) . Conclusion Soft tissue tumor, especially some large lesions, could uptake bone tracer 99m Tc⁃MDP and the uptake level were gradeⅡ-Ⅲ mostly. Malignancy should be highly suspected when the soft tissues uptake 99m Tc⁃MDP in skeleton imaging.
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