^(99m)Tc-MDP对肢体高压电损伤的诊断价值

Utility of ^(99m)Tc-MDP Imaging in the Evaluation of Limbs Injury with High Voltage Electric Burn

目的研究应用99mTc-亚甲基二磷酸盐(MDP)评估高压电烧伤患者肢体受损程度。方法46例肢体高压电烧伤患者,分别于术前进行99mTc-MDP显影、彩色多普勒检测,术中观察组织大体改变,出现血管栓塞或组织坏死者予以切除并进行组织病理学检查。结果轻度损伤肢体血池相及血流相均显示局部放射性浓聚,重度损伤肢体远端影像暗淡,近端影像明显增强,毁损性电击伤肢体血流灌注中断,各种组织均不显影,与未受损影像界限清晰,与彩色多普勒检测、临床表现和组织病理学检查相符。结论99mTc-MDP三相动态显像可直观显示深度电烧伤后局部血供及组织受损情况,是判断电烧伤患者组织损伤情况的理想方法。

Objective To explore the utility of ^99mTc-methylene diphosphonate （^99mTc-MDP） imaging in the evaluation of limbs injury in patients inflicted with electric burn. Methods 46 patients with high voltage electric injury of limbs were enrolled in the study. The wounds were examined by preoperative ^99mTc-MDP imaging and color Doppler ultrasonography,and the changes of the tissue were evaluated during operation. Thrombotic vessels and/or necrotic tissue were excised and verified by pathomorpholngieal examination. Results Blood pool imaging and flow imaging in the minor injured limbs showed high radioactivity in the wound. The images in the serious injured limbs were thin in the distal end ,but obviously thicker in the proximal side. The blood flow of the destroyed limbs showed broken off,and all kinds of tissue could not be visualized with clear edges in images. Preoperative color Doppler ultrasonic diagnostic, observation during operation and postoperative pathomorphological findings were consistent with ^99mTc-MDP imaging. Conclusion ^99mTc-MDP triphase dynamic imaging of the tissue injuries in patients with electric bum is an ideal screening test because it can intuitively show the changes of the tissue and blood flow.