99Tcm-MDP骨显像左侧股骨颈放射性计数比值评价骨质疏松的价值

Application of left femoral neck radioactive uptake ratio in 99Tcm-MDP bone scan for evaluation of osteoporosis

目的 评价99Tcm-MDP全身骨显像时左侧股骨颈放射性摄取对诊断骨质疏松的价值.方法 选取2012年5月至2012年12月脊柱关节病患者58例,其中男23例,女35例,年龄51 ～ 85(66.15±8.45)岁.用双能X线吸收测定法(DXA)检测骨密度(BMD),并按BMD测定结果将患者分为2组:骨量正常组(T值＞-1.0)和骨质疏松组(T值≤-2.5).分别测定2组患者的血浆Ⅰ型胶原羧基末端肽(sCTX-1)及骨型ALP(BALP)水平,并行99Tcm-MDP全身骨显像,计算左侧股骨颈(T)和左股骨颈中段内侧软组织(N)的平均放射性比值T/N.应用两样本t检验及Pearson相关分析对2组患者相关资料进行统计学处理.结果 BMD测定结果示,骨量正常组13例(男7例,女6例),骨质疏松组28例(男10例,女18例).骨质疏松组患者的平均年龄明显大于骨量正常组[(68.82±10.41)岁与(62.46± 11.77)岁;t=3.560,P＜0.05],其左侧股骨颈BMD明显低于骨量正常组[(0.67±0.08)与(0.91±0.10) g/cm2;t=9.917,P＜0.01],其骨代谢标志物BALP的含量明显高于骨量正常组[(35.92± 11.58)与(22.38±6.34) U/L;t=-3.397,P＜0.05],而2组间sCTX-1的含量差异无统计学意义(t=-0.463,P＞0.05).骨质疏松组左侧股骨颈T/N值(11.63±6.22)较骨量正常组(9.74±4.44)明显增高(t=-3.027,P＜0.05),其与年龄、BMI、BMD无明显相关性(r=-2.031、-0.017、0.134,均P＞0.05),而与sCTX-1及BALP均呈正相关(r=0.376和0.483,均P＜0.01).结论 99Tcm-MDP全身骨显像时所测左侧股骨颈T/N值能较好评价全身骨代谢情况,对于骨质疏松的早期诊断有一定价值.

Objective To evaluate the value of 99Tcm-MDP uptake by left femoral neck for diagnosing osteopomsis.Methods A total of 58 cases (23 males,35 females,mean age:(66.15±8.45) years) with spondyloarthmpathies from May to December of 2012 were selected.Serum concentrations of type Ⅰ collagen telopeptide (sCTX-1) and bone ALP (BALP) were determined.All patients underwent dual-energy X-ray absorptiometry (DXA) to detect bone mineral density (BMD).According to the T scores,patients were divided into 2 groups:normal group (NG) (T＞-1.0) and osteoporosis group (OG) (T≤-2.5).99TcmMDP bone scan was further performed.The average radioactive ratio of the left femoral neck to the medial soft tissue of left femur (T/N) was measured.Data differences between the 2 groups were compared by twosample t test and Pearson correlation analysis.Results According to BMD,13 patients (7 males,6 females) were included in NG and 28 patients (10 males,18 females) were included in OG.The mean ages of OG and NG were significantly different ((68.82± 10.41) years vs (62.46± 11.77) years; t =3.560,P＜0.05).The BMD of left femoral neck in OG was significantly lower than that in NG ((0.67±0.08) g/cm2 vs (0.91±0.10) g/cm2 ; t=9.917,P＜0.01).Although BALP level of OG was significantly higher than that of NG ((35.92±11.58) U/L vs (22.38±6.34) U/L; t=-3.397,P＜0.05),no significant difference was observed on sCTX-1 between the 2 groups (t=-0.463,P＞0.05).T/N ratio of OG (11.63±6.22) was higher than that of NG (9.74±4.44) (t =-3.027,P＜ 0.05).There were significant correlations between the T/N ratio of the left femoral neck and the sCTX-1 and BALP concentrations (r=0.376,0.483,both P＜0.01).No correlations between the T/N ratio of the left femoral neck and age,BMI and BMD were observed (r=-2.031,-0.017,0.134,all P＞0.05).Conclusion The uptake ratio of the left femoral neck in 99Tcm-MDP bone scan could evaluate the metabolism of bone,and it is useful for the early diagnosis of osteoporosis.