[1]刘玉珂,张敏,李培岭,等.99Tcm-MDP SPECT/CT融合骨显像评价骨折远期愈合能力的应用价值[J].国际放射医学核医学杂志,2018,(3):218-223.[doi:10.3760/cma.j.issn.1673-4114.2018.03.005]
　Liu Yuke,Zhang Min,Li Peiling,et al.Evaluation of fracture healing by 99Tcm-MDP SPECT/CT[J].International Journal of Radiation Medicine and Nuclear Medicine,2018,(3):218-223.[doi:10.3760/cma.j.issn.1673-4114.2018.03.005]
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《国际放射医学核医学杂志》[ISSN:1673-4114/CN:12-1381/R]

卷:
期数:
2018年第3期
页码:
218-223
栏目:
单光子显像在临床中的应用
出版日期:
2018-05-25

文章信息/Info

Title:
Evaluation of fracture healing by 99Tcm-MDP SPECT/CT
作者:
刘玉珂;  张敏;  李培岭;  王娜;  赵振江;  郭会利;  张斌青
471002, 河南省洛阳正骨医院(河南省骨科医院)影像中心
Author(s):
Liu Yuke;  Zhang Min;  Li Peiling;  Wang Na;  Zhao Zhenjiang;  Guo Huili;  Zhang Binqing
Medical Imaging Center, Luoyang Orthopedic Hospital of Henan Province, Orthopedic Hospital of Henan Province, Luoyang 471002, China
关键词:
骨折愈合; 单光子发射计算机体层摄影术; 亚甲基二膦酸盐
Keywords:
Fracture healing; Single photon emission computed tomography computed tomography; Methylene diphosphonate
DOI:
10.3760/cma.j.issn.1673-4114.2018.03.005
摘要:
目的 探讨99Tcm-MDP SPECT/CT融合骨显像技术评价骨折远期愈合能力的应用价值。方法 回顾性分析2008年1月至2017年8月在我院治疗至少超过6个月的76例骨折患者的影像资料，其中58例经手术治疗，18例采用非手术方法治疗，所有骨折患者均未达到临床愈合标准。对76例骨折患者行SPECT显像、CT扫描和SPECT/CT融合骨显像，分析骨折端的放射性分布及CT特征，观察骨折端放射性浓聚是否连续性通过骨折线，跨越两侧骨折端，评价骨折远期愈合能力，最终骨折愈合情况经临床随访或手术证实。结果 76例骨折患者， 58例SPECT/CT融合骨显像显示放射性浓聚连续性通过骨折线并跨越两侧骨折端，诊断为骨折具有远期愈合能力，经对症保守治疗，证实52例骨折远期愈合，6例未愈合，SPECT/CT对骨折远期愈合诊断的准确率达89.66%（52/58）。18例骨折端未见明显连续性通过骨折线的放射性浓聚，诊断为骨折不愈合，且不具备远期愈合能力，均进行了手术治疗并证实为骨折不愈合，SPECT/CT对骨折远期不愈合诊断的准确率达100%（18/18）。结论 SPECT/CT融合骨显像可较准确地评价骨折的远期愈合能力，具有重要的临床应用价值。
Abstract:
Objective To explore the application value of SPECT/CT on fracture healing. Methods A retrospective analysis was done among 76 patients with fracture as evidenced by image data from January 2008 to August 2017. Fifty-eight cases with fracture revealed by a SPECT/CT fusion image with surgical treatment, 18 cases with nonsurgical treatment, and 76 cases of bone fracture clinical healing that failed to meet standards were retrospectively analyzed after more than 6 months of treatment. A SPECT/CT image fusion imaging device was applied to 76 cases of fracture detected with SPECT, CT scan, and SPECT/CT fusion imaging. The characteristics of the fractures in terms of radioactive distribution and CT were examined, and the radioactive strength of the fracture was observed to determine whether radioactivity passed continuously through the fracture line or crossed both sides of the fracture. The healing ability of the fracture was evaluated, and fracture healing cases were confirmed through surgery or clinical follow-up. Results A total of 76 fractures were collected and examined through SPECT/CT, and 58 cases of uptake that passed through the fracture line and crossed on both sides of the fracture end were obtained. This finding indicated that the fracture was in the process of healing and that fracture could heal. Furthermore, 52 cases were confirmed after conservative treatment was administered, and 6 cases of fracture were nonunion. For 18 cases, no nuclide concentration was detected in the fracture end, and the fracture was nonunion. The final diagnosis was confirmed through surgery, and the diagnostic accuracy rates were 89.66%(52/58) for fracture healing and 100%(18/18) for nonunion. Conclusion SPECT/CT imaging could accurately evaluate fracture healing and had an important application value.

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备注/Memo

备注/Memo:
收稿日期:2018-03-12。
基金项目:河南省科技攻关项目（182102311207）
通讯作者:张敏,Email:yukeliu1975@163.com
更新日期/Last Update: 2018-05-25