^(99)Tc^m-亚甲基二膦酸盐在肢体高压电损伤中的诊断价值

The utility of technetium-99m methylene diphosphonate imaging in the evaluation of limbs injury with high voltage electric burn

目的研究应用99Tcm-亚甲基二膦酸盐(MDP)评估高压电烧伤患者肢体受损程度。方法选取46例肢体高压电烧伤患者,分别于术前进行99Tcm-MDP显影、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,与彩色多普勒超声检测、临床表现和组织病理学检查相符。结论Tcm-MDP三相动态显像可较直观地显示深度电烧伤后局部血供99的改变及组织受损情况,它可以作为诊断电烧伤患者组织损伤程度的一种检测手段。

Objective To explore the utility oftechnetium-99m methylene diphosphonate （^99Tc^m-MDP） imaging in the evaluation of limbs injury in patients inflicted with electric burn. Methods Forty six patients with high voltage electric injury of limbs were enrolled in the study, The wounds were examined by preoperative ^99Tc^m--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 verificated by pathomorphological examination. Results Blood pool imaging and flow imaging in the minor injured limbs showed thicker tracer accumulation 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 ^99Tc^m- -MDP imaging. Conclusion ^99Tc^m-- MDP triphase dynamic imaging of the tissue injuries in patients with electric burn is a good screening test because it can intuitively show the changes of the tissue and blood flow.