鎝-99m標幟亞甲基雙磷酸骨骼掃描的肝脾集積現象

Hepatic and Splenic Accumulation of 99mtc-Methylene Diphosphonate

10.6332/ANMS.1404.015

陳建仲(Chien-Chung Chen)；潘玫秀(Mei-Shiu Pan)；顏若芳(Ruoh-Fang Yen)

鎝-99m標幟亞甲基雙磷酸 ； 放射藥物製備失當 ； 彌漫性肝 ； 脾集積 ； 99mTc-MDP ； improper preparation of radiopharmaceutical ； diffuse accumulation of liver and spleen

核子醫學雜誌

14卷4期（2001 / 12 / 01）

251 - 255

繁體中文

一位59歲男性膀胱移型細胞癌患者，手術後接受鎝-99m標幟亞甲基雙磷酸（99mTc-MDP）全身骨骼掃描以評估是否有骨轉移。檢查結果發現除正常的骨骼集積外，併有罕見的瀰漫性肝、脾集積現象。此現象可能為放射藥物製備失當、腫瘤內集積或是其他病理、生理因素引起。在第一次掃描的72小時後，患者接受了另一次掃描以利判別。結果除了正常的骨骼集積外，彌漫性的肝、脾集積現象消失了。在逐項排除原因後，我們認為第一次掃描所見的肝、脾集積應為放射藥物製備失當引起的可能性較高。一般所知鎝-99m-MDP為特異集積於骨骼的放射影像製劑，其對於骨骼的集積率相當高，肝、脾的顯影並不多見。本文為藉此病例探討鎝-99mTc-MDP肝、脾集積的可能原因。

This 59-year-old man is a case of bladder transitional cell carcinoma. 99mTc-methylene diphosphonate (99mTc-MDP) whole body bone scan was arranged for staging work-up. The image showed normal osseous uptake with accidental finding of diffuse tracer accumulation in liver and spleen. Repeated whole body bone scan 72 h later disclosed no definite hepatic and splenic accumulation. Summary from the review literature, diffuse tracer uptake in liver and spleen could be due to improper preparation of radiopharmaceutical, tumor avidity, pathologic or physiologic basis. Out of which ”improper preparation of radiopharmaceutical” is the most likely cause in this case. 99mTc-MDP is a bone-seeking agent with high skeletal system accumulation. Visualization of liver and spleen in 99mTc-MDP bone scan is uncommon. In this article, we reviewed the possible mechanisms and causes of hepatic and splenic accumulation in 99mTc-MDP bone scan.