^(99)Tc^m-MDP骨显像在监测大段同种异体骨与带血管蒂自体腓骨复合移植的价值

^(99)Tc^m-MDP bone scan in the transplantation of massive allograft combined with vascularized fibular autograft

目的 利用99Tcm MDP骨显像对复合骨移植进行监测 ,并与X线检查及组织学检查进行对比 ,以探讨骨显像对评价移植骨成活的价值。方法 将 12只杂种犬制备成实验动物模型 ,随机分成实验组和对照组。术后第 1、2、3、4个月分别行X线摄片、组织学观察、全身99Tcm MDP骨显像。利用ROI技术 ,计算两组动物植骨区与对侧健肢的放射性计数和摄取比值。结果 X线示实验组较同时期对照组异体骨吸收、新骨形成明显。组织学检查 :实验组较同期对照组异体骨 宿主骨结合端、异体髓腔内壁及哈弗管内的骨吸收、成骨活动更活跃。骨显像 :实验组较同期对照组骨代谢活跃 ,骨显像结果与组织学变化规律相似 ,均为术后 1、2个月活跃 ,于第 2个月达高峰 ,第 3、4个月呈下降趋势。结论 99Tcm MDP骨显像与组织学结果吻合 ,但更具连续性而便于自身对照 ,与X线片相比更具直观性、准确性。

Objective To investigate the value of 99 Tc m-MDP bone scan in the transplantation of massive allograft combined with vascularized fibular autograft. Methods The bone critical-sized massive defect animal models were made by skeletally mature 12 dogs which were randomly divided into experimental and control groups.The assessments that included X-ray,gross specimen,histological studies as well as bone scintigraphy were performed at 1,2,3,4 month after operation,respectively. Results In the same period,the experimental group revealed allograft bone resorption and bone formation more significantly in X-ray than the control group. Histological observation showed that,there was significantly greater new bone callus formation and bone resorption in the allograft-host bone junction and haversian system in the experimental group than in the control group.The bone scan showed that bone metabolism were more active at 1,2 month,and it reached its peak at 2 month, then it had a decreasing tendency at 3,4 month postoperation. Conclusion The result of monitoring for the bone transplantation by radionuclide bone imaging is accorded with histomorphometry,comparing with X-ray,it is more accurate and direct.