^(99)Tc^m-枸橼酸盐和^(99)Tc^m(Ⅴ)-DMSA显像诊断急性化脓性骨关节炎  

A study on ^(99)Tc^m-citrate and ^(99)Tc^m(Ⅴ)-DMSA imaging in the diagnosis of acute purulent osteoarthritis

作　　者：武兆忠[1] 范子文[2] 林伟[1] 吴波以[2] 邬恒夫[1] 吴长伟[1] 袁戈文[1] 

机构地区：[1]广州医学院附属第二医院核医学科,510260 [2]广州医学院附属第二医院骨科,510260

出　　处：《中华核医学杂志》2003年第4期239-240,共2页Chinese Journal of Nuclear Medicine

基　　金：广东省医学科研基金资助项目 (B1 9980 63)

摘　　要：目的　探讨99Tcm 枸橼酸盐和99Tcm(Ⅴ ) 二巯基丁二酸 (DMSA)显像对急性化脓性骨关节炎的诊断价值。方法　 17例急性化脓性骨关节炎患者和 19例非化脓性骨关节病患者分别行99Tcm 亚甲基二膦酸盐 (MDP)、99Tcm 枸橼酸盐和99Tcm(Ⅴ ) DMSA显像 ,行半定量分析。结果　 3种显像剂在急性化脓性骨关节炎病灶处均有明显趋骨性浓集 ;非化脓性骨关节病病灶处99Tcm MDP和99Tcm(Ⅴ ) DMSA有明显趋骨性浓集 ,99Tcm 枸橼酸盐仅有轻度趋骨性浓集 ,后者还可见周围软组织放射性浓集。半定量分析示 ,急性化脓性骨关节炎99Tcm 枸橼酸盐显像靶与非靶组织 (L N)比值 (2 30 0± 0 0 94 )明显高于非化脓性骨关节病 (1 2 98± 0 0 5 4 ,P <0 0 1) ;99Tcm(Ⅴ ) DMSA显像L N比值分别为 3 4 95±0 180和 3 0 91± 0 0 91,差异无显著性 (P >0 0 5 )。结论　联合应用99Tcm 枸橼酸盐和99Tcm(Ⅴ ) DMSA或99Tcm MDP显像能无创地评估骨组织炎症的病理生理状态。99Tcm 枸橼酸盐显像可显示骨组织炎症累及范围 ,而后两者可显示炎症所致骨组织代谢增高范围。Objective To assess the clinical diagnostic value of 99Tcm-citrate and 99Tcm(Ⅴ)-dimercaptosuccinic acid (DMSA) imaging in the acute purulent osteoarthritis. Methods Seventeen patients with confirmed acute purulent osteoarthritis and nineteen patients with non-purulent osteoarthritis were studied. In all patients, 99Tcm-methylene diphosphonic acid (MDP), 99Tcm-citrate and 99Tcm(Ⅴ)-DMSA imaging were sequentially performed and the images were analyzed semiquantitatively. Results In the acute purulent osteoarthritis group, there were positive bonetactic accumulations at certain areas on the three kinds of imaging. In the non-purulent osteoarthritis group, 99Tcm-MDP and 99Tcm(Ⅴ)-DMSA imaging showed clear bonetactic accumulation, but 99Tcm-citrate imaging showed only light bonetactic accumulation in addition to the accumulations in soft tissue at certain areas. Lesion to nonlesion ratio(L/N=2.300±0.094) of acute purulent osteoarthritis was greater than that in non-purulent osteoarthritis group (1 298±0.054, P<0.01) in 99Tcm-citrate imaging, and there was no significant difference between two groups on 99Tcm(Ⅴ)-DMSA imaging (L/N ratio of acute purulent osteoarthritis group was 3.495±0.180, and L/N ratio of non-purulent osteoarthritis group was 3.091±0.091, P>0.05). Conclusions To diagnose the bone inflammation, 99Tcm-citrate imaging coalesced with 99Tcm-MDP or 99Tcm(Ⅴ)-DMSA imaging can help to evaluate the pathologic and physiologic progresses in bone inflammatory areas, at the same time, the information by 99Tcm-citrate imaging is telling the actual inflammation areas, and that by 99Tcm(Ⅴ)-DMSA and 99Tcm-MDP imaging is about the response to the increase of bone metabolism.

关 键 词：急性化脓性骨关节炎 诊断 ^99Tc^m—枸橼酸盐 ^99Tc^m(Ⅴ)—DMSA 放射性核素显像 

分 类 号：R817.4[医药卫生—影像医学与核医学]