^(99m)Tc-MDP三相骨显像对疲劳性骨膜炎的诊断价值  

Diagnostic Value of ^(99m)Tc-MDP Three-phase Bone Scintigraphy for Fatigue Periostitis

作　　者：黄展辉[1] 高荣光[1] 郭晶晶[2] 张盼[3] 

机构地区：[1]福州总医院核医学科,福建福州350000 [2]福建医科大学附属协和医院超声科 [3]福州总医院影像科,福建福州350000

出　　处：《华南国防医学杂志》2017年第6期368-371,共4页Military Medical Journal of South China

基　　金：福州总医院军事医学研究专项(2016J03)

摘　　要：目的探讨^(99m)锝-亚甲基二磷酸盐[(99m)Tc-methylene diphosphonate,^(99m)Tc-MDP]三相骨显像对疲劳性骨膜炎的诊断价值。方法将41例疲劳性骨膜炎患者按腿部疼痛出现后是否继续训练分为A、B两组,分别行三相骨显像及X线检查。分析并总结两组疲劳性骨膜炎在血流灌注相、血池相及延迟相中的放射性分布特点,并对患侧感兴趣区(region of interest,ROI)/健侧ROI的放射性计数比值进行比较分析。结果病变部位于血流灌注相、血池相及延迟相均可见异常放射性增强灶;发病后继续训练的患者患侧ROI/健侧ROI血池相及延迟相的放射性计数比值均大于发病后立即停止训练的患者。结论三相骨显像能够全面综合的观察疲劳性骨膜炎病变部位动脉血流灌注、血管床和骨盐代谢情况,对于疲劳性骨膜炎早期诊断有重要意义;还可判断疲劳性骨膜炎的轻重程度以及与训练的关系,对于该病的临床治疗以及部队合理训练新兵起到重要作用。Objective To discuss the diagnostic value of （99m） Tc-methylene diphosphonate（99mTc-MDP） three- phase bone scintigraphy for fatigue periostitis. Methods A total of 41 cases were divided into A, B groups according to patients with fatigue periostitis whether or not continue training, and took the three-phase bone scintigraphy and X-ray. The radioactive distribution characteristics of fatigue periostitis in three-phase bone scintigraphy of blood perfusion phase, blood pool phase and delayed phase were analyzed and summarized. The radioactive count ratio of affected side region of interest （ ROI ）/uninjured side ROI was compared and analyzed. Results The diseased region had abnormal radioactive enhanced lesions in three phases. The radioactive count ratios of affected side ROI/uninjured side ROI in blood pool phase and delayed phase of patients to continue training were higher than those of patients to stop training. Conclusion Three- phase bone scintigraphy comprehensively observe the arterial perfusion, vascular bed and metabolism of bone salt in diseased region of fatigue periostitis, and have important significance for early diagnosis of fatigue periostitis. It can also esti- mate the degree of fatigue periostitis, relationship between training and play an important role for clinical treatment as well as reasonable training of recruits in army.

关 键 词：疲劳性骨膜炎 三相骨显像 应力性损伤 99m锝-亚甲基二磷酸盐 

分 类 号：R681.2[医药卫生—骨科学]