SPECT／CT骨显像诊断兔应力性骨折的实验研究  

Experimental Study on SPECT/CT Bone Fusion Imaging in Diagnosis of Stress Fracture in Rabbit

作　　者：蔡良[1] 曾贵刚[2] 乔伟伟[3] 石洪成[1] 张申[2] 陈曙光[1] 胡鹏程[1] 李蓓蕾[1] 

机构地区：[1]复旦大学附属中山医院核医学科,上海200032 [2]第二军医大学附属长征医院中医理疗科,上海200003 [3]复旦大学实验动物科学部,上海200032

出　　处：《实验动物与比较医学》2013年第4期265-270,共6页Laboratory Animal and Comparative Medicine

基　　金：上海市科委基金项目（10140903603）

摘　　要：目的探讨SPECT／CT（Single—Photon Emission Computed Tomography／Computed Tomography）骨融合显像在应力性骨折（stressfracture，SF）诊断方面较单纯骨平面显像（BoneScintigraphy，Bs）诊断的增益价值。方法雄性新西兰白兔12只，随机分为2组，实验组8只，根据实验方案进行特制的跑跳训练，持续5周；对照组4只，让其自由活动5周。实验组和对照组均进行^99Tc^m-亚甲基二膦酸盐（methylene diphosphonate，MDP）骨平面显像和SPECT／CT骨融合显像。由专业医师双盲法判读骨平面图像、骨SPECT图像和SPECT／CT骨融合显像图像，诊断有无应力性骨折病灶，并与对应胫骨的病理诊断进行对比分析。结果骨平面显像诊断应办性骨折的灵敏度、特异性以及准确性分别为31．25％（5／16）、87．50％（7／8）、50．00％（12／24）；SPECT／CT骨融合显像诊断应力性骨折的灵敏度、特异性和准确性分别为75．00％（12／16）、87．50％（7／8）和79．17％（19／24）。结论在诊断应力性骨折方面，SPECT／CT骨融合显像较单纯99Tcm—MDP骨显像有增益价值，提高了诊断的准确性。Objective To discuss the gain value of SPECT/CT bone fusion imaging and bone planar scintigraphy in the diagnosis of stress fracture. Methods Twelve male New Zealand White rabbits were randomly divided into two groups, including 8 in the experimental group and 4 in the control. In the experimental group, 8 rabbits were given electronic stimulation regularly to let it jump in a special device for five weeks. Meanwhile, the control group was allowed for free activities. All of them had undergone both 99Tcm-MDP bone planar imaging and SPECT/CT bone fusion imaging. All of bone planar images, bone SPECT images and SPECT/CT fusion images were diagnosis by 2 nuclear medicine physicians in double-blind method. All results were confirmed by pathological examination. Results The sensitivity, specificity and accuracy of bone planar imaging diagnosis of stress fracture were 31.25 % （5/16）, 87.50%（7/8） and 50.00%（12/24）, respectively; the sensitivity, specificity and accuracy of SPECT/CT bone fusion imaging in the diagnosis of stress fracture were 75.00 % （12/16）, 87.50 % （7/8） and 79.17 % （19/24）. Conclusions SPECT/CT bone fusion imaging has a higher sensitivity and specificity in the diagnosis of stress fracture, and it can further improve the diagnostic accuracy.

关 键 词：应力性骨折 放射性核素骨显像 单光子发射型计算机体层摄影术 X线计算机体层摄影术 亚甲基二膦酸盐 

分 类 号：R683[医药卫生—骨科学] R-332[医药卫生—外科学]