Marks P H, Goldenberg J A, Vezina W C, Chamberlain M J, Vellet A D, Fowler P J
Division of Orthopedic Surgery, University Hospital, London, Ontario, Canada.
J Nucl Med. 1992 Apr;33(4):516-20.
Bone scintigraphy is used to detect radiographically silent fractures. Magnetic resonance imaging (MRI) is currently used to screen knee injuries for cartilage and ligament damage. MRI also delineates bone marrow and fractures. We investigated the bone scintigraphic findings in patients who had subchondral bone injuries demonstrated on MRI. Thirteen patients underwent MRI, three-phase bone scintigraphy with SPECT, and arthroscopic surgery after sustaining acute traumatic hemarthrosis of a knee. They all had clinically unsuspected subchondral bone injuries demonstrated on MRI with normal radiographs and normal overlying articular cartilage at arthroscopy, consistent with occult fractures. All showed focal bone repair on scintigraphy. Two of the 13 patients showed additional bone injuries only on bone scan. Two other patients scintigraphically showed focal bone repair at the medial femoral condyle due to avulsion of the medial collateral ligament. SPECT was easier to interpret than multi-view planar imaging. Bone scintigraphy confirms subchondral fractures demonstrated on MRI but also demonstrates ligament avulsion injuries and additional more subtle bone injuries.
骨闪烁扫描术用于检测X线片显示不出的骨折。磁共振成像（MRI）目前用于筛查膝关节损伤的软骨和韧带损伤情况。MRI还可描绘骨髓和骨折情况。我们对MRI显示有软骨下骨损伤的患者的骨闪烁扫描结果进行了研究。13例患者在膝关节急性创伤性关节积血后接受了MRI、三相骨闪烁扫描及单光子发射计算机断层扫描（SPECT）检查和关节镜手术。他们在MRI上均显示有临床未怀疑的软骨下骨损伤，X线片正常，关节镜检查时关节软骨表面正常，符合隐匿性骨折。所有患者在闪烁扫描上均显示有局灶性骨修复。13例患者中有2例仅在骨扫描上显示有额外的骨损伤。另外2例患者在闪烁扫描上显示由于内侧副韧带撕脱导致股骨内侧髁局灶性骨修复。SPECT比多视角平面成像更容易解读。骨闪烁扫描术证实了MRI显示的软骨下骨折，但也显示出韧带撕脱伤和其他更细微的骨损伤。
