SPECT/CT融合骨显像评价四肢骨折远期愈合  

SPECT/CT fusion of bone scintigraphy in evaluation on long-term healing of limb fractures

作　　者：刘玉珂 李培岭 郭会利 王娜 孟庆阳 姚太顺 孟宪杰 LIU Yuke;LI Peiling;GUO Huili;WANG Na;MENG Qingyang;YAO Taishun;MENG Xianjie(Medical Imaging Center, Luoyang Orthopedic Hospital of Henan Province, Orthopedic Hospital of Henan Province, Luoyang 471002, China)

机构地区：[1]河南省洛阳正骨医院(河南省骨科医院)影像中心,河南洛阳471002

出　　处：《中国医学影像技术》2018年第5期751-754,共4页Chinese Journal of Medical Imaging Technology

基　　金：河南省科技攻关项目(182102311207)

摘　　要：目的探讨SPECT/CT融合骨显像技术评价四肢骨折远期愈合情况的价值。方法回顾性分析68例四肢骨折患者经治疗6个月后骨折端SPECT/CT融合骨显像特征,判断骨折愈合情况,并与临床随诊或手术情况对照,计算SPECT/CT判断骨折能否远期愈合的准确率。结果 68例四肢骨折,X线或CT检查均不能明确判断骨折能否远期愈合。SPECT/CT融合骨显像中,52例患者见连续性放射浓聚通过骨折线并跨越两侧骨折端,提示骨折处于愈合进程中,具有远期愈合可能;经临床随诊证实46例骨折愈合,6例未愈合。16例骨折端未见明显连续性通过骨折线的放射性浓聚,提示骨折不愈合,且远期愈合的可能性较小;均经手术治疗并证实为骨折不愈合。SPECT/CT融合骨显像判断骨折愈合的准确率为91.18%(62/68)。结论 SPECT/CT融合骨显像可准确评价四肢骨折远期愈合情况,对指导临床制定骨折治疗方案具有重要价值。Objective To explore the value of SPECT/CT in evaluation on long-term healing of limb fractures.Methods SPECT/CT imaging characteristics of 68 patients with limb fractures 6 months after treatment were analyzed retrospectively,and the self-healing property of fractures was evaluated.Compared with clinical follow-up results or surgical findings,the accuracy of SPECT/CT in evaluation on long-term healing of fractures was calculated.Results For all 68 patients with limb fractures,X-ray and CT were not able to determine whether the fractures would heal in the future.On SPECT/CT fusion images,radioactivity concentrations through the fracture lines and cross on both sides of fracture were found in 52 patients,which indicated that the fractures were in the process of healing and had the ability of healing in the future.Clinical follow-up confirmed that fractures then healed in 46 patients,while in 6 patients did not.Another 16 patients showed no nuclide concentrations on the fractures,indicated that the fractures were nonunion and had little ability of healing in the future,and were finally confirmed with surgery.The accuracy of SPECT/CT in evaluation on fracture healing was 91.18%（62/68）.Conclusion SPECT/CT imaging can accurately evaluate the long-term healing of limb fractures,which contributes to therapeutic planning in the clinic.

关 键 词：骨折愈合 体层摄影术 发射型计算机 单光子 体层摄影术 X线计算机 亚甲基二磷酸盐 

分 类 号：R683[医药卫生—骨科学] R817.4[医药卫生—外科学]