Cerebral Infarction Mimicking Skeletal Metastases on Tc-99m MDP Bone Scintigraphy.
- Author:
Suk Tae LIM
;
Soon Ae PARK
;
Myung Hee SON
;
Chang Yeol LIM
- Publication Type:Original Article
- Keywords:
Cerebral Infarction;
Skeletal Metastases;
Tc-99m MDP;
Bone Scintigraphy
- MeSH:
Blood-Brain Barrier;
Brain;
Cerebral Infarction*;
Extracellular Space;
Humans;
Male;
Middle Aged;
Neoplasm Metastasis*;
Prostate;
Radionuclide Imaging*;
Ribs;
Skull;
Spine;
Technetium Tc 99m Medronate*
- From:Korean Journal of Nuclear Medicine
2000;34(5):433-435
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
A 60-year-old male with carcinoma of the prostate and cerebral infarction underwent a Tc-99m MDP bone scintigraphy for the evaluation of skeletal metastases. Bone scintigraphy (Fig. 1) showed multiple areas of increased uptake of Tc-99m MDP in the skull, spine, and ribs representing skeletal metastases. Two different patterns of uptake occurred in the skull region (Fig. 1A-C); one represents bony metastasis and the other represents cerebral infarction. The shape, size, location, intensity, and border of the increased uptake differed between the two lesions. An oval-shaped pattern with smaller size, greater intensity and more sharply defined border in the frontal region was consistent with bony metastasis. A rectangular-shaped pattern with larger size, lesser intensity and relatively indistinct border in the temporo-parieto-occipital region was consistent with cerebral infarction. Increased uptake of bone-seeking radiotracers in cerebral infarction has been reported previously.1-4) A suggested mechanism by which bone-seeking radiotracers accumulate in the necrotizing cerebral tissue is an alteration of the blood-brain barrier induced during cerebral infarction, which results in entry of the radiotracers into the extracellular space of the brain.4) Brain CT (Fig. 2) performed 7 days before and one month after the bone scintigraphy revealed lesions on the right temporo-parieto-occipital region consistent with acute hemorrhagic and chronic cerebral infarction, respectively.
