摘要
目的探讨99Tc^m-MDP SPECT全身骨显像联合局部SPECT/CT融合显像对骨质疏松患者功能不全性骨折(IF)的诊断价值。方法回顾性分析2012年12月至2017年6月于河南省骨科医院收治的90例符合骨质疏松症诊断标准的患者的99Tc^m-MDP SPECT全身骨显像和阳性部位的局部SPECT/CT融合显像结果,分析联合显像对IF的临床诊断效能。90例患者中,男性32例、女性58例,年龄(67.56±7.68)岁,其中22例可疑IF、68例已确诊局部IF。所有患者的最终诊断结果均经过6个月以上临床及影像学随访证实。结果99Tc^m-MDP SPECT全身骨显像共检出IF病灶234个,均表现为显像剂摄取增高,病变部位及个数为骨盆78个、腰椎49个、胸椎46个、肋骨45个、股骨8个、胫骨4个、跟骨3个及胸骨1个。全身骨显像联合局部SPECT/CT融合显像对IF的诊断灵敏度为100%(234/234)。68.89%(62/90)的患者联合显像检出的IF数目多于显像之前已知的骨折数目。在局部SPECT/CT融合显像检查范围内,CT显示骨折病灶293个,其中SPECT/CT诊断新鲜IF病灶234个、陈旧性IF病灶59个,SPECT/CT对新鲜IF的诊断灵敏度为100%(234/234)。结论99Tc^m-MDP SPECT全身骨显像联合局部SPECT/CT融合显像对骨质疏松患者IF病灶数目的全身显示及诊断具有较高的临床应用价值。
Objective To investigate the diagnostic value of 99Tc^m-MDP SPECT whole-body bone scan and local SPECT/CT tomography fusion imaging for insufficiency fracture(IF).Methods Ninety patients(including 32 males and 58 females,aged 67.56±7.68,22 cases with suspected IF,68 cases with confirmed local IF)who were either diagnosed with IF in their partial skeleton or suspected to suffer from IF were enrolled in this study.The diagnostic value of 99Tc^m-MDP SPECT whole-body bone scan and local SPECT/CT tomography fusion imaging for IF were retrospectively analyzed.The correct diagnosis were confirmed by clinical assessment and over 6 months of imaging follow-up.Results A total of 234 lesions were detected in 90 patients by 99Tc^m-MDP SPECT whole-body bone scan,which showed high radioactivity in all lesions.The common sites of the lesions were the pelvis(78 lesions),lumbar vertebrae(49 lesions),thoracic vertebrae(46 lesions),ribs(45 lesions),femur(8 lesions),tibia(4 lesions),calcaneus(3 lesions),and sternus(1 lesion).The sensitivity of 99Tc^m-MDP whole-body bone scan and local SPECT/CT tomography fusion imaging for IF was 100%(234/234).A greater number of lesions were determined in approximately 68.89%(62/90)of the patients by combined imaging than the lesions which were confirmed as IF before combined imaging.A total of 293 fractures were identified in the scope of CT examination;of these,234 were diagnosed as acute fractures and 59 were diagnosed as chronic fractures by SPECT/CT.The diagnostic sensitivity of SPECT/CT toward acute IF was 100%(234/234).Conclusion 99Tc^m-MDP SPECT whole body-bone scan and local SPECT/CT fusion imaging has high clinical value in the systemic display and diagnosis of IF in patients with osteoporosis.
作者
张斌青
张国庆
刘玉珂
郭会利
Zhang Binqing;Zhang Guoqing;Liu Yuke;Guo Huili(Department of Medical Imaging Center,Luoyang Orthopedic Hospital of Henan Province,Orthopedic Hospital of Henan Province,Luoyang 471002,China)
出处
《国际放射医学核医学杂志》
2020年第7期411-415,共5页
International Journal of Radiation Medicine and Nuclear Medicine
