核素骨显像在严重急性呼吸综合征患者恢复期骨坏死诊断中的应用价值

Clinical Application of Radionuclide Bone Scintigraphy in Diagnosis of Avascular Osteonecrosis in Patients with Severe Acute Respiratory Syndrome in Convalescence

目的评估核素骨显像在严重急性呼吸综合征(SARS)患者恢复期骨坏死诊断中的应用价值。方法对69例康复后4～6个月的SARS患者行股骨头区99Tcm-MDP骨三相及全身骨扫描,并与同期MRI结果进行比较。结果骨三相发现16例患者31个股骨头呈不同阶段、不同程度的典型骨坏死表现,其中97%有MRI异常;23例患者42个股骨头为可疑坏死,其中67%为MRI阴性;30例正常表现患者中3例MRI为可疑。全身骨扫描发现29例患者有其他部位异常,包括15例膝关节骨坏死。结论核素骨显像对检出极早期骨坏死具有优势,其价值与MRI互补。

Objective To evaluate the clinical value of radionuclide bone scintigraphy in diagnosis of avascular osteonecrosis in patients with severe acute respiratory syndrome We performed three-phase bone scintigraphy of femoral head regions patients 4-6 months after they recovered from the syndrome, and then co （SARS） in convalescence. Methods and whole-body bone scan in SARS mpared the results with simultaneous MRI. Results Typical avascular necrosis at different stages and severities was found on bone scintigraphy at 31 femoral heads of 16 SARS patients, 97% of which were MRI positive. Suspicious necrosis was found at 42 femoral heads of 23 patients, 67% of which were MRI negative. Among 30 patients with normal three-phase scintigraphic results, 10% of whom were suspicious on MRI. In addition, abnormal distributions of radioactivity were observed in other bones on the whole-body bone scans of 29 patients, including osteonecrosis of knees in 15 patients. Conclusions Radionuclide bone scintigraphy is valuable in early diagnosis of osteonecrosis in SARS patients in convalescence. It provides a mutually supplementary tool for MRI.