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氟离子与骨组织中的羟基磷灰石晶体羟基交换形成氟磷灰石。18F-NaF在成骨性和溶骨性病变中的摄取反映局部血流以及骨转换的加快[5]。18F-NaF的摄取机制与99Tcm-MDP相似, 但是18F-NaF比99Tcm-MDP具有更好的药代动力学特性, 包括更快的血液清除速度以及在骨组织中2倍的摄取量[3, 6]。
虽然18F-NaF和99Tcm-MDP在剂量学上相似, 然而18F-NaF PET/CT检查花费时间更短(18F-NaF PET/CT和99Tcm-MDP骨扫描检查花费时间分别为1~2.5 h和2~3 h), 且能够更快得到诊断[5]。18F-NaF PET/CT在检测骨病变方面比常规骨扫描更灵敏。99Tcm-MDP骨扫描对成骨性病变和溶骨性病变的检出率相近, 而18F-NaF PET/CT拥有更高的检出率并且能更准确地区分良恶性病变[7-8]。除了药代动力学上的优越性, 18F-NaF能够在生产18F-FDG的加速器上轻易获得。因此, 考虑到18F-NaF PET/CT比99Tcm-MDP骨扫描具备更优越的特性及改变治疗方式的潜力和应用的简便性, 18F-NaF PET/CT有潜力在诊断骨转移方面替代99Tcm-MDP骨扫描[9]。18F-NaF PET/CT和99Tcm-MDP骨扫描的比较见表 1。
Table 1. Compare with 18F-NaF PET/CT and 99Tcm-MDP bone scan
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