核素骨显像诊断SARS激素治疗后恢复期缺血性骨坏死的价值  

Radionuclide bone scintigraphy in early detection of avascular osteonecrosis occurred in recovered SARS patients after hormone therapy

作　　者：王茜[1] 黄俐俐[1] 秦淑玲[1] 王玉[1] 聂玉新[1] 梁铁军[1] 张彩群[1] 赵亚妹[1] 

机构地区：[1]北京大学人民医院核医学科,100044

出　　处：《中华核医学杂志》2005年第6期329-332,共4页Chinese Journal of Nuclear Medicine

基　　金：留学回国人员科研启动基金(2001-345)

摘　　要：目的探讨重症急性呼吸综合征(SARS)恢复期患者的骨显像特征,评价骨显像对早期诊断缺血性骨坏死(AVN)的价值。方法 66例 SARS 恢复期患者行核素全身骨显像,其中54例同时行髋、膝关节 MRI 检查。对患者的骨显像结果进行分析,同时与 MRI 检查结果对照,并根据随访结果评价两种检查法早期诊断 AVN 的价值。结果骨显像发现30例(45.5%)患者异常。共发现病灶82个,分别位于髋、膝、踝、肘、肩、腕和胫骨中段,以髋、膝关节病变最为常见。其中有症状病灶71个,无症状病灶11个。多发病灶见于8例患者。骨显像与 MRI 诊断结果符合率为92.6%。与随访结果对照,骨显像和 MRI 对髋和膝关节 AVN 诊断的准确性相同(均为91.7%)。骨显像还检出11个位于 MRI 扫描视野外的病灶。结论 SARS 恢复期患者发生 AVN 的可能性较高,且呈多部位受累倾向;骨显像宜作为早期诊断 AVN 的首选检查法。Objective To analyze the characteristics of bone scintigraphy in patients who recovered from the severe acute respiratory syndrome （SARS） , and to evaluate the clinical value of bone scintigraphy in the early diagnosis of avascular osteoneerosis （AVN） after hormone therapy. Methods Bone scintigraphy was performed in 66 SARS patients. Among them 54 underwent MRI in bilateral hips and knees. Both images were compared and followed up clinically. Results Abnormal scintigraphy was found in 30 （45, 5% ） of the 66 recovered SARS patients. Total 82 foci were found in hip, knee, ankle, elbow, shoulder, wrist and the middle of the tibia. Hip and knee joints were the most involved sites, 25 patients with 71 lesions were symptomatic, whereas 11 in 5 patients were asymptomatic, lesions in 8 patients were muhifocal. The lesions found in scintigraphy and MRI were concordant in 92.6% of the joints, But more lesions could be detected by bone scintigraphy. Conclusions SARS patients have a high occurrence of AVN, usually involved in multiple sites, Bone scintigraphy should be the first choice method used for early detection of AVN.

关 键 词：骨坏死 体层摄影术 发射型计算机 单光子 重症急性呼吸综合征 MDP 

分 类 号：R511.9[医药卫生—内科学] R817.4[医药卫生—临床医学]