核素全身骨显像定量分析对肾性骨病的诊断意义  

Tne significance of quantitative analysis of whole body bone seintigraphy (WBBS) in renal osteodystrophy

作　　者：翟德佩[1] 杨立昌[2] 高硕[2] 徐家华 周荫保[2] 

机构地区：[1]天津医学院附属医院肾科,300052 [2]天津医学院附属医院核医学科,300052

出　　处：《肾脏病与透析肾移植杂志》1993年第1期62-65,109,共5页Chinese Journal of Nephrology,Dialysis & Transplantation

摘　　要：对45例正常人及16例肾脏病患者进行了全身核素^(99)Tc^m-MDP骨显像定量分析。根据骨骼摄取示踪剂程度的不同,将显像分为高、中、低三个活性等级(以Y,R,G表示),并与X线检查结果比较。16例患者均显示全身骨代谢明显异常,表现Y及R区显著增高(P<0.001),而X线检查仅10例显示有骨病征象。4例经维生素D治疗前后的核素扫描对比,显示Y区有明显下降,但X线检查未见明显变化。表明全身核素骨扫描对肾性骨病的早期诊断、鉴别诊断和疗效评价有较重要意义,为一有价值的诊断方法。The quantitative analysis of WBBS was performed on 45 control group (20 males and 25 females, aged 18～64 years) and 16 patients (6 males, 10 females, aged 17～54 years, CGN 10 cases, RTA 4 cases, polycystic kidney Faneoni's syndrome 1 case respectively). The WBBS was performed on all the subjects 3h after Ⅳ of 20 mci of ^(99m)TC-MDP, using Gemini-700 SRECT system with MCS-560 computer. The colors were arranged to show decreasing tracer uptake in the order of yellow(Y), red (R) and green (G). The values obtained from total area were taken as 100%, and the area ratio of each grade was then calculated. Results in the anterior scan Y=9.1±3.3%(control: 3.9±1.0%, P<0.001), R=26.8±2.9% (control: 24±2.2%, P<0.001) and G=64.1±4.6% (control: 72.1±2.9%, P<0.001) and in the posterior scan Y=10.6±3.5% (control: 5.2±1.0%, P<0.001), R=25.0±2.7%(control: 21.5±2.3%, P<0.001) and G=64.4±4.4% (control: 73.3±2.7%, P<0.001). As dynamic observation the WBBS was performed on 4 patients before and after treatment with Vit D for 3～6 months. The results in anterior scan Y=1.1±1.9% (after treatment: 6.8±2.1%, P<0.001), posterion scan Y=12.2±0.8% (after treatment: 9.0±1.2%, P<0.05). The results revealed that all 16 cases' WBBS were abnormal, while only 10 cases showed abnormal changes in X-ray. Besides as to psudofracture WBBS showed 47 psudofractures in 5 patients, but bone radiography showed 5 psudofractures in 2 paticnts. So, WBBS is superior to bone radiography for detecting early renal osteodystrophy and psudofracture. In dynamic observations the decrease of quantitative Y values were found in all of 4 cases. It suggests that the patients' increased bone turnover start to improve, but no any changes on bone radiography. As a conclusion the quantitative analysis of WBBS may be used as a valuable routine method for curly diagnosis, differential diagnosis and evaluating the therapeutic effects in renal osteodystrophy.

关 键 词：全身骨显像定量分析 肾性骨病 ^99mTC 亚甲基二磷酸盐(MDP) 

分 类 号：R5[医药卫生—内科学]