^(99m)Tc-MDP骨显像对兔股骨头缺血性坏死模型的实验研究  

Experiment research of avascular necrosis of the femoral head in rabbits by bone imaging of ^(99m)Tc-MDP

作　　者：杜明华[1] 钟瑛[1] 朱丹杰[1] 

机构地区：[1]东南大学附属中大医院,南京210009

出　　处：《核技术》2006年第10期782-786,共5页Nuclear Techniques

摘　　要：本研究是建立阻断股骨头动脉的股骨头缺血模型,通过分别阻断实验兔股骨头旋股内、外侧动脉,观察99mTc-MDP骨显像对于股骨头血流、代谢变化,及组织学改变。将实验兔分成三组:A组,结扎旋股内、外侧动脉;B组,结扎旋股内侧动脉;C组,结扎旋股外侧动脉。所有实验兔在术前均由耳缘静脉注入99mTc-MDP37MBq,然后于术后两小时至八周应用SPECT检测实验侧股骨头(E头)、实验侧股骨干(E干)、对照侧股骨头(C头)、对照侧股骨干(C干)放射性计数,并计算比值和动态检测股骨头血流量及代谢的改变。结果是A组B组骨显像结果相同,手术当日及术后三日均可见兔实验侧股骨头放射性缺损,于术后一周开始出现放射性浓聚,至术后四周达高峰,术后八周仍有明显放射性浓聚,呈持续性高代谢反应状态。C组各时期三相骨显像结果与A、B组不同,手术当日可见兔实验侧股骨头放射性缺损,于术后三日即开始出现放射性浓聚,术后一周、四周均可见放射性浓聚,于术后八周即完全恢复。①E头/C头比值:1.020±0.063,C头/C干比值:2.721±0.086。②A组和B组结扎旋股动脉术后两小时和三天E头/C头和E头/E干比值明显下降,术后一周至八周血供重建,两组间无显著性差异(P>0.05);③C组E头/C头和E头/E干比值轻度下降,术后三天血供重建,比值增高不显著,与前两组之间均有显著性差异(P<0.05)。这说明:1.旋股内侧动脉及其分支为股骨头主要供血动脉;2.99mTc-MDP骨显像定量分析是评价ANFH的好方法。To observe the viability of blood flow and revascularization and pathological change after ligating different blood vessels supplying femoral head and to provide basis of choosing different treatment of avascular necrosis of femoral head （ANFH）, the medial and lateral femoral circumflex arteries of rabbits were ligated for different groups. Group A ligated both medial and lateral femoral circumflex arteries; Group B ligated the medial femoral circumflex arteries; and Group C ligated the lateral femoral circumflex arteries. All rabbits were given an injection of ^99mTc-MDP of 37 MBq via anterior auricular veins before the operation. The radioactive counts of experimental femoral head （Ehead）, experimental femoral shaft （Eshaft）, control femoral head （Chead） and control femoral shaft （Cshaft） of rabbits were measured by SPECT in the 2 h, 3 d, 1 w （week）, 4 w and 8 w after operation. The results show that ① Ehead/Chead is 1.020±0.063 and Chead/Cshaft is 2.72. ②Ehead/Chead and Ehead/Eshaft of groups A and B decreased distinctly. The blood supply was reestablished in 1-8 weeks after the operation. No significant difference was found between these two groups （P 〉 0.05）. ③Ehead/Chead and Ehead/Eshaft of group C decreased indistincdvly. The blood supply was reestablished after the postoperative at 3 d and the ratio increased indistinctly. Significant difference was found between group C and group A or B （P 〈 0.05）. It is concluded that the medial femoral circumflex artery is the main blood vessel supplying the femoral head, and the quantitative analysis of ^99mTc-MDP bone imaging is a good method to evaluate the ANFH.

关 键 词：股骨头缺血性坏死 血液供应 单光子发射计算机断层 

分 类 号：R814.42[医药卫生—影像医学与核医学] R681.8[医药卫生—放射医学]