曹剑鸣 宋建华 张红 650032 昆明医学院第一附属医院核医学科(曹剑鸣、张红)，口腔颌面外科(宋建华) 中华核医学杂志 1999 0 0 2


    关键词：口腔；颌疾病；外科；手术；骨；放射性核素显像 期刊 zhhyxzz 0 论著 fur -->


    

摘要 目的 探讨骨显像对口腔颌面部病变的诊断和鉴别诊断的临床价值。方法 用⁹⁹ Tc^m -亚甲基二膦酸(MDP)对5例正常人,15例患者(3例下颌骨造釉细胞瘤、5例口腔内鳞状细胞癌、2例下颌胚胎型横纹肌肉瘤、1例舌血管瘤、1例下颌骨肉瘤、1例下颌骨囊肿、1例腮腺慢性炎症和1例拔牙后患者)进行三相骨显像、断层显像和半定量分析。结果 3例下颌骨造釉细胞瘤均表现为⁹⁹ Tc^m -MDP浓聚,5例口腔鳞癌和下颌胚胎型横纹肌肉瘤侵犯下颌骨者，病灶/颈椎(L/C)值>1,下颌骨未受累者L/C值<1;舌血管瘤的骨血流、血池相均示病灶处异常放射性浓聚,延迟相则浓聚影明显变淡、消退；拔牙后患处牙槽骨显示异常放射性浓聚,但L/C值<1;下颌骨恶性肿瘤病灶骨显像亦显示异常放射性浓聚,L/S值为1.01。结论 骨三相及骨断层显像半定量分析可用于口腔颌面外科疾病的诊断和鉴别诊断，并且有助于确定病灶范围和软组织病变有无累及颌骨，对指导确定治疗方案有一定意义。

    The Preliminary application of boneimaging in oral and maxillofacial surgical patients

CAO Jianming,SONG Jianhua,ZHANGHong.The First Affiliated Hospital,Kunming Medicalcollege,Kunming 650032

Abstract Objective Toevaluate theclinical value of bone imaging for the diagnosis and differential diagnosis oforal and maxillofacial surgical patients and toclarify whether the mandible is invaded bythe adjacent lesion.Methods Routine planar three-phase bonescintigraphy and semiquantitative mandibular tomography were performed on 5controls and 15patients.Of these 15 patients,3cases were with ameloblastoma of mandible,5cases withintraoral squamouscarcinoma,2cases with embryonal rhabdomyosarcoma,1case with hemangiomaof tongue,1case with sarcoma of mandible,1case with mandibularcyst,1case withchronicparotitis and 1 postextraction patient.Results All of 3 ameloblastomasof mandible showed high uptake of ⁹⁹ Tc^m -MDP.The mandibles invadedby intraoral squamouscarcinoma and the embryonal rhabdomyosarcoma showed that the ratio oflesion-to-cervical vertibrae (L/C) was more than 1; the mandibles not invaded by intraoralsquamouscarcinoma and embryonal rhabdomyosarcoma showed that the L/C was less than 1; thetongue hemangioma showed a high uptake of ⁹⁹ Tc^m -MDP in blood flowphase and blood pool phase,but no high uptake of ⁹⁹ Tc^m -MDP inbone imaging.For the postextractioncase,the alveolar bone showed a high uptake of ⁹⁹ Tc^m -MDPin mandibular tomography,but L/C was less than 1; mandibularcarcinomas showed a highuptake of ⁹⁹ Tc^m -MDP in mandibular tomography,L/C was 1.01.Conclusions Routineplanar three-phase bone scintigraphy and semiquantitative mandibular tomography is auseful method for the diagnosis and differential diagnosis of diseases in oral andmaxillofacial surgery,and it is also helpful for finding out the limits of foci andinvasion of mandibles by the lesions in adjacent tissue inclinical practising.

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