风湿性骨关节炎患者99mTc-MDP骨显像的初步应用  

A Clinical Study on the Diagnosis of Early Rheumatoid Arthritis Using Bone Imaging with ^(99m)Tc-MDP

作　　者：青春[1] 雷勇[1,2] 马丽莉[1,2] 解朋[1] 邓候富[1] 

机构地区：[1]四川大学华西医院核医学科,成都610041 [2]深圳红十字医院核医学科,深圳518029

出　　处：《生物医学工程学杂志》2008年第5期1193-1196,共4页Journal of Biomedical Engineering

摘　　要：为了解风湿性骨关节病的骨显像应用价值,我们对66例临床确诊的风湿性骨关节病患者行99m锝-亚甲基二膦酸(99mTechnetium methylenediphosphonate,99mTc-MDP)全身及局部骨显像以及感兴趣区(Region of interest,ROI)测定,并进行骨关节疼痛部位X线检查,测定血清类风湿因子(Rheumatoid factor,RF)、血清C反应蛋白(C-reactive protein,CRP)及血沉(Erythrocyte sedimentation rate,ESR)。结果66例中骨关节显像阳性55例,阳性率为83.3%,明显高于X线(45.5%)、RF(51.5%)、CRP(63.6%)、ESR(69.7%)。病程<1、1~、5~、>10年患者99mTc-MDP显像阳性率分别为75.0%、88.9%、92.3%、100.0%,X线阳性率分别为10.7%、33.3%、84.6%、100.0%(两者比较,病程5年以内P<0.01,病程5年以上P>0.05)。99mTc-MDP显像发现骨关节病灶177个,对称性病灶144个(81.4%)明显多于单发病灶(33个,18.6%),其影像改变常见于指间、掌指、腕和跖踝关节。我们可以看到99mTc-MDP显像能较早发现风湿性骨关节病的异常改变,对治疗有一定的指导意义。This study aimed to explore the usefulness of 99Technetium methylenediphosphonate （99mTc-MDP） hone imaging in diagnosticating rheumatoid arthritis （RA）. In 66 patients with RA, 99mTc-MDP whole body bone imaging, feet and hands regional hone imaging and ROI were performed. And from each patient, X-ray film, rheumatoid fac- tor （RF）, C-reactive protein （CRP） and erythrocyte sedimentation rate （ESR） were taken for examination. By the use of 99mTc-MDP, abnormal hone images were observed in 55 cases of RA; the total positive rate of incidence （83.3%） was significantly higher than those by use of X-ray （45.5%）, RF （51.5%）, CRP （63.6%） and ESR （69.7%） ; the posirive rates of imaging with 99mTc-MDP in the 55 cases of RA（divided into 4 groups according to the course of disease; namely, 〈1,1--, 5-- and 〉10-year groups） were 75.0%, 88.9%, 92.3% and 100.0% respectively, whereas the positive rates of those year-groups by use of X-ray were 10.7%, 33.3%, 84.6%, 100.0% respectively; comparison of the two methods, showed statistically significant difference： P〈0.01 （〈5-year group） ; P〉0.05 （ 〉5-year group）. In 177 joint lesions detected by hone images, 144 lesions （81.4%） were symmetric, and 33 lesions （18.6%） were single. The most frequently detected lesions were at metacarpophalangeal joints or interphalangeal and wrist joints, metatarsophalangeal or ankle joints, andknee joints. We have noticed that 99mTc-MDP bone imaging can elevate the detectability at the early stage of RA, so it is of value for the treatment of RA.

关 键 词：风湿性骨关节炎 99m锝-亚甲基二膦酸 放射性药物 骨关节显像 

分 类 号：R817.4[医药卫生—影像医学与核医学]