SPECT/CT融合显像评价下肢骨折远期愈合的初步探讨

Preliminary discussion of evaluating of long-term healing of lower limb fractures with SPECT/CT fusion bone imaging

目的:探讨SPECT/CT融合显像在评价下肢骨折远期愈合能力方面的价值。方法:回顾性分析59例下肢骨折患者术后6个月后的SPECT/CT融合图像,分析骨折愈合情况,并与随访或手术比较,计算SPECT/CT融合显像对下肢骨折远期愈合的诊断准确率。结果:59例常规影像学检查均不能判断是否具有远期愈合可能。SPECT/CT示51例放射性核素通过骨折线,提示具有远期愈合的可能;其中,44例随访X线显示愈合,7例手术治疗后X线片显示未愈合。8例SPECT/CT融合显像未见放射性核素通过骨折线,提示骨折不愈合,愈合可能性较小;经再次手术证实为骨折不愈合。SPECT/CT诊断骨折愈合的准确率为88.1%(52/59)。结论:SPECT/CT可较准确地评价骨折远期愈合情况,对临床具有很大的指导意义。

Objective:To explore the value of SPECT/CT in evaluation on long-term healing of Lower limb fracture.Methods:SPECT/CT imaging characteristics of 59 patients with lower limb fracture 6 months after treatment were analyzed retrospectively,and the self-healing property of fracture was evaluated.Compared with clinical follow-up results or surgical findings,the accuracy of SPECT/CT in evaluation on long-term healing of fracture was calculated.Results:For all 59 patients with lower limb fractures,X-ray or CT were not able to determine whether the fractures would heal in the fracture.On SPECT/CT fusion images,radionuclide through the fracture lines and cross on both sides of fracture were found in 51 patients,which indicated that the fractures were in the process of healing and had the ability of healing in the future.Clinical follow-up results or surgical findings confirmed that fracture then healed in 44 patients,while in 7 patients did not.8 patients showed no radionuclides through the fracture lines on SPECT/CT images,indicated that the fractures were nonunion and had little ability of healing in the future,which were finally confirmed by a second surgery.The accuracy of SPECT/CT in evaluation on fracture healing was 88.1%(52/59).Conclusion:SPECT/CT could evaluate the long-term healing of limb fractures more accurately,which contributes to therapeutic planning in the clinic.