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Tc 99m diphosphonates concentrate in cerebral lesions only when the bloodbrain barrier has been damaged by cerebral infarction (ref) , tumor or inflammation. Bone tracers also localize in extraaxial lesions such as subdural hematomas, meningiomas (ref) and dural calcifications. (ref)
Uptake in the head |
Uptake in the neck |
|---|---|
| Abscess | Arterial calcification |
| Arteriovenous malformations | Calcified hemorrhagic cyst |
| Cerebral Infarction | Congenital fibromatosis |
| Cerebritis | Hypercalcemia |
| Chronic subdural hematoma | Multinodular goiter |
| Cysticercosis | Normal thyroid cartilage |
| Dural calcifications | Thyroid adenoma |
| Metastases | Thyroid medullary carcinoma |
| Primary neoplasms | Thyroid papillary adenocarcinoma |
| Astrocytoma | Trauma from nasogastric tube |
| Acoustic neuroma | Free pertechnetate |
| Meningioma |
Cerebral infarction (ref).
An anterior image of a bone scintigram (A) shows increased uptake in
the left parietal region, which corresponds to an area of decreased
attenuation on an unenhanced CT (B).
Cerebral infarction (ref).
Anterior (A) and lateral (B) images of a bone scintigram show
increased uptake in the left parietal region, which corresponds to an
area of decreased attenuation on an unenhanced CT (C).
Meningioma (ref).
Posterior (A) and lateral (B) bone scintigraphic images show
increased uptake in the right posterior fossa, which correspond to a
heavily calcified mass seen on an unenhanced CT (C).
C
Dural Calcification (ref)
(A) Anterior and (B) lateral views of a bone scintigram show
increased radiotracer accumulation along the superior mid-sagittal plane
and asymmetric radiotracer uptake along the left fronto-temporal region.
(C) Lateral view of the skull demonstrates dense calcifications of the
dural falx.
A.
B.
Free Pertechnetate
(A-B) Bone scintigrams in anterior view show increased radiotracer accumulation in the expected region of the oral cavity and the thyroid glands.