DeNucci D J, Chen C C, Sobiski C, Meehan S
National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, Maryland, USA .
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000 Dec;90(6):750-7. doi: 10.1067/moe.2000.105906.
The purpose of this study was to investigate the potential usefulness of single photon emission computed tomography (SPECT) bone scanning with technetium-99m methylene diphosphonate (Tc-99m MDP) in the diagnosis of idiopathic jaw pain. Unlike planar bone scanning, SPECT uses tomographic technology to provide 3-dimensional images, which are more useful in localizing small lesions.
Twenty patients, each with a diagnosis of chronic idiopathic jaw pain, were compared after SPECT bone scanning with 20 age-matched and gender-matched normal controls. Uptake was identified and compared in sites with previously detected jaw pathoses and jaw pain.
Nineteen of 20 patients with jaw pain evaluated with SPECT had positive scans, in contrast with 12 of 20 control subjects (P <.04). Positive scans were correlated with painful sites in 15 of 20 patients, with the remaining 5 patients demonstrating no uptake in painful locations. Patients with jaw pain demonstrated 37 of 80 mouth quadrants with positive scans, in contrast with 21 of 80 mouth quadrants in the controls (P <.01). Nineteen of 24 painful mouth quadrants had uptake in the pain group. Of the 21 quadrants positive in the controls, 17 were correlated with previously detected jaw pathoses. The sensitivity and specificity for detecting painful sites were 0.79 and 0.68, respectively. The sensitivity and specificity for detecting previously identified pathoses in the jaws of normal controls were 0. 80 and 0.93, respectively.
Patients with idiopathic jaw pain had a significantly greater frequency of positive SPECT bone scans when compared with normal controls. However, the sensitivity and specificity of SPECT bone scans in detecting painful sites were low. These findings suggest that SPECT bone scanning with Tc-99m MDP is not indicated as a routine imaging procedure for the detection of jaw pathoses, but may be considered as a potential research tool in the future study of chronic idiopathic jaw pain.
本研究旨在探讨使用锝-99m亚甲基二膦酸盐（Tc-99m MDP）进行单光子发射计算机断层扫描（SPECT）骨扫描在特发性颌面部疼痛诊断中的潜在效用。与平面骨扫描不同，SPECT使用断层扫描技术来提供三维图像，这在定位小病变方面更有用。
20例诊断为慢性特发性颌面部疼痛的患者在进行SPECT骨扫描后，与20例年龄和性别匹配的正常对照进行比较。对先前检测到的颌面部病变部位和颌面部疼痛部位的摄取情况进行识别和比较。
20例接受SPECT评估的颌面部疼痛患者中有19例扫描结果为阳性，而20例对照受试者中有12例（P <.04）。20例患者中有15例的阳性扫描结果与疼痛部位相关，其余5例患者在疼痛部位未显示摄取。颌面部疼痛患者的80个口腔象限中有37个扫描结果为阳性，而对照组的80个口腔象限中有21个（P <.01）。疼痛组的24个疼痛口腔象限中有19个有摄取。在对照组中呈阳性的21个象限中，有17个与先前检测到的颌面部病变相关。检测疼痛部位的敏感性和特异性分别为0.79和0.68。在正常对照的颌骨中检测先前确定的病变的敏感性和特异性分别为0.80和0.93。
与正常对照相比，特发性颌面部疼痛患者的SPECT骨扫描阳性频率显著更高。然而，SPECT骨扫描在检测疼痛部位方面的敏感性和特异性较低。这些发现表明，使用Tc-99m MDP进行SPECT骨扫描不作为检测颌面部病变的常规成像程序，但在未来慢性特发性颌面部疼痛的研究中可能被视为一种潜在的研究工具。
