摘要
目的：探讨99Tcm-MDP血流、血池及延迟的SPECT/CT融合显像在骨关节置换术后关节感染与无菌性假体松动诊断中的应用价值。方法：回顾性分析14例关节置换术后出现关节疼痛的患者资料，所有患者均行99Tcm-MDP血流、血池及延迟的SPECT/CT融合显像，采用视觉分析法，并与细菌培养、C反应蛋白、血红细胞沉降率及术后病理等对照。结果：与最终临床诊断比较，以单纯延迟的SPECT/CT融合显像骨-假体弥漫性放射性浓聚诊断为关节感染，其灵敏度、特异度及准确率分别为80%、77.78％、78.6%；如以血流或血池相任意阳性结合延迟的SPECT/CT融合显像阳性诊断关节感染，其灵敏度、特异度及准确率分别为100%、88.89%、92.9%。结论：延迟的SPECT/CT融合显像可以对假体松动和感染的具体部位进行精准定位，99Tcm-MDP血流、血池结合延迟的SPECT/CT融合显像，在关节置换术后假体松动和感染的鉴别诊断中，有较高的临床应用价值。
Abstract
Objective: To investigate the value of 99Tcm-MDP triple phase bone imaging for the differential diagnosis of prosthesis loosening and joint infection after arthroplasty. Methods: 14 patients with joint pain after joint arthroplasty underwent triphase SPECT/CT bone imaging. By visual analysis, the bone imaging results were validated with the findings of germiculture, serum C reative protein(CRP), erythrocyte sedimentation rate(ESR) and biopsy. Results: The final clinical diagnosis was taken as gold standard. If diffuse radioactivity in the bone and prosthesis simply by delayed phase was considered joint infection, the diagnostic sensitivity, specificity and accuracy were 80%, 77.78% and 78.6%, respectively. When increased uptake of isotopes in the blood flow or pool phase as well as positive findings in the delayed phase as the criterion of joint infection, the diagnostic sensitivity, specificity and accuracy were 100%, 88.89% and 92.9%, respectively. Conclusion: Delayed SPECT/CT hybrid imaging may precisely indicate the position of prosthesis loosening and joint infection. By combination of 99Tcm-MDP blood flow and pool imaging, it showed higher clinical value in differentiating joint infection from prosthesis loosening after arthroplasty.
关键词
关节成形术 /
置换 /
髋 /
体层摄影术 /
发射型计算机 /
单光子 /
体层摄影术 /
螺旋计算机
Key words
Arthroplasty /
replacement /
hip /
Tomography /
emission-computed /
single-photon /
Tomography /
spiral computed
邓咏梅;张金山;李 园;袁文金.
SPECT/CT骨三相显像在关节置换术后假体松动与感染诊断中的应用[J]. 中国临床医学影像杂志. 2015, 26(1): 44-46
DENG Yong-mei;ZHANG Jin-shan;LI Yuan;YUAN Wen-jin.
SPECT/CT triphase bone imaging for the differential diagnosis of prothesis loosening andjoint infection after arthroplasty[J]. Journal of China Clinic Medical Imaging. 2015, 26(1): 44-46
中图分类号：
Ｒ687.4
R814.42
Ｒ817.4
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