99Tc^m-MDP骨三相联合SPECT/CT骨显像评价人工关节置换术后疼痛的研究进展  

Progress of 99Tc^m-MDP three phase bone scan combined with hybrid bone SPECT/CT in the evaluation of pain after artificial joint replacement

作　　者：张欣韵 孙贞魁[1] 朱瑞森[1] 罗全勇[1] Zhang Xinyun;Sun Zhenkui;Zhu Ruisen;Luo Quanyong(Department of Nuclear Medicine,Shanghai JiaoTong University,the Affiliated Sixth People's Hospital,Shanghai 200233,China)

机构地区：[1]上海交通大学附属第六人民医院核医学科,200233

出　　处：《国际放射医学核医学杂志》2019年第1期76-81,共6页International Journal of Radiation Medicine and Nuclear Medicine

摘　　要：人工关节置换术后出现复发性或持续顽固性疼痛的情况并不少见,然而,关节内外生物力学与生物学等诸多因素导致临床难以及时明确疼痛原因及部位。解剖学影像虽可提供生物力学结构变化及假体解剖部位异常等信息,但却无法明确关节置换术后引起疼痛的部位及原因。99Tc^m-MDP骨三相联合SPECT/CT骨显像可将反映骨代谢活性及应力性改变所引起的骨代谢变化与CT所提供的解剖学信息完美融合,从而更好地显示显像剂99Tc^m-MDP的摄取分布及摄取程度和关节内生物力学及其他解剖学结构异常。笔者就人工关节置换的指征、术后疼痛的病因分析及SPECT/CT骨显像在髋与膝关节置换术后疼痛评估中的临床应用作一综述,并结合临床实践整理了部分典型病例图像。Recurrent or persistent intractable pain is quite common after surgical intervention,such as joint replacement.However,the biomechanics and biological factors inside and outside the joint make it difficult to identify the potential cause and precise painful sites.Although anatomical images can provide information on the biomechanical and anatomical changes around the prosthesis,it is impossible to identify the site and cause of pain after joint replacement.To show the distribution and identify intra -articular biomechanics and other structural alterations,bone tracers such as 99Tc^m-MDP are used.Three-phase 99Tc^m-MDP bone scintigraphy and hybrid SPECT/CT images can allow the identification of metabolic alterations caused by changes in metabolic activity and bone reaction.This review presents the clinical indications of artificial joint replacements,etiologies of postoperative pain,and clinical applications of fused SPECT/CT images in pain evaluation after hip or knee joint replacement.

关 键 词：骨关节成形术 置换 单光子发射计算机体层摄影术 术后疼痛 骨显像 

分 类 号：R687.4[医药卫生—骨科学] R817.4[医药卫生—外科学]