Tc 99m diphosphonates concentrate in cerebral lesions only when the bloodbrain barrier has been damaged by cerebral infarction 1, 2 , tumor or inflammation. Bone tracers also localize in extraaxial lesions such as subdural hematomas, meningiomas 3, 4, 5 and dural calcifications. 6
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
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
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
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
(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) Bone scintigrams in anterior view show increased radiotracer accumulation in the expected region of the oral cavity and the thyroid glands.
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- 2. [2225666] "Incidental demonstration of cerebral infarction on bone scintigraphy in sickle cell disease." Clin Nucl Med. 1990;15:671-2.
- 3. [1770649] "[Intracranial accumulation of 99mTc-phosphorous compound on bone scintigraphy]." Kaku Igaku. 1991;28:1343-7.
- 4. [1424360] "Fracture of the laryngeal cartilage. An incidental finding on bone scintigraphy." Clin Nucl Med. 1992;17:815-7.
- 5. [1934801] "Serendipitous diagnosis of hyperthyroidism with Tc-99m bone scan." Clin Nucl Med. 1991;16:526.
- 6. [630771] "A dural calcification presenting as a solitary lesion on radionuclide bone scan." Clin Nucl Med. 1978;3:35.