三种无创性方法早期诊断兔激素性股骨头坏死的对比研究

Comparative study of three non-invasive methods for early diagnosis of steroid-induced femoral head necrosis in rabbits

目的比较磁共振成像(MRI)、^(99m)Tc-亚甲基二膦酸盐(^(99m)Tc-MDP)显像、^(99m)Tc-半胱氨酸-膜联蛋白V(^(99m)Tc-Cys-Annexin V,TP5-3)单光子发射计算机断层(SPECT)显像在激素性股骨头坏死(SIFHN)模型兔中的早期诊断价值。方法收集2022年1月至2022年12月36只新西兰大白兔,采用随机数字表法分为模型组20只、对照组16只。模型组通过注射马血清和激素建立早期动物模型,对照组注射等量生理盐水。分别于造模后的第2周、第4周分批进行MRI、^(99m)Tc-Cys-Annexin V显像及^(99m)Tc-MDP显像,影像学检查完毕行病理组织学观察验证。计量资料组间比较为t检验,计数资料组间比较为卡方检验。结果造模第2周(超早期阶段),模型组MRI和^(99m)Tc-MDP显像均未见骨坏死的异常信号,^(99m)Tc-Cys-Annexin V SPECT显像可见双侧股骨头异常放射性浓聚,其诊断价值高于MRI和^(99m)Tc-MDP显像。造模第4周(早期阶段),MRI、^(99m)Tc-MDP显像和^(99m)Tc-Cys-Annexin V SPECT显像均可检出骨坏死的异常信号,MRI检出阳性率[55.56%(5/9)]高于^(99m)Tc-MDP显像[44.44%(4/9)],而^(99m)Tc-Cys-Annexin V SPECT显像最低[33.33%(3/9)],三者比较差异无统计学意义(χ^(2)=0.90,P>0.05)。结论^(99m)Tc-Cys-Annexin V SPECT显像可在超早期检出SIFHN,但在早期仍推荐MRI检测。

Objective To compare the early diagnostic value of magnetic resonance imaging(MRI),Technetium[^(99m)Tc]methylenediphosphonate injection(^(99m)Tc-MDP)imaging and ^(99m)Tc-Cys-Annexin V single-photon emission computed tomography(SPECT)imaging in animal models of steroid-induced femoral head necrosis(SIFHN)in rabbits.Methods A total of 36 healthy New Zealand white rabbits aged 5-month-old were collected from January 2022 to December 2022,and they were randomly divided into a model group(n=20)and a control group(n=16).The model group was injected with horse serum and hormone to establish the early animal model,and the control group was injected with the same amount of normal saline.MRI,^(99m)Tc-Cys-Annexin V imaging and ^(99m)Tc-MDP bone imaging were performed in batches at the 2nd and 4th week after the model was made respectively,and histopathological observation and verification were performed after the imaging examinations.The comparison between count data sets was performed by t-test,and the comparison between count data sets was done by Chi-square test.ResultsAt the 2nd week of modeling(ultra-early stage),MRI and ^(99m)Tc-MDP imaging in the model group showed no abnormal signal of osteonecrosis,and ^(99m)Tc-Cys-Annexin V SPECT imaging showed abnormal radioactive concentration of bilateral femoral head.The diagnostic value of ^(99m)Tc-Cys-Annexin V SPECT imaging was higher than that of MRI and ^(99m)Tc-MDP imaging.MRI,^(99m)Tc-MDP imaging and ^(99m)Tc-Cys-Annexin V SPECT imaging could detect the abnormal signal of osteonecrosis at the 4th week(early stage)after modeling,the positive rate of MRI[55.56%(5/9)]was higher than that of ^(99m)Tc-MDP[44.44%(4/9)],but the lowest was ^(99m)Tc-Cys-Annexin V SPECT[33.33%(3/9)].There was no significant difference among the three methods(χ^(2)=0.90,P>0.05).Conclusion ^(99m)Tc-Cys-Annexin V SPECT imaging can detect SIFHN in the ultra-early stage,but MRI is still recommended in the early stage.