Patel N, Collier B D, Carrera G F, Hanel D P, Sanger J R, Matloub H S, Hackbarth D A, Krasnow A Z, Hellman R S, Isitman A T
Department of Radiology, Medical College of Wisconsin, Milwaukee.
Clin Nucl Med. 1992 Jun;17(6):449-53. doi: 10.1097/00003072-199206000-00004.
Bony anatomic landmarks of the wrist (e.g., pisiform, hook of hamate, radioulnar joint, and styloid processes of the radius and ulna) were routinely identified in 28 adult patients examined for wrist pain. With the wrists prone and immobilized, bone scintigrams were obtained for 500,000 counts with an asymmetric (133 to 161 keV) Tc-99m energy window and either a converging (best choice) or straight-bore, high-resolution collimator. High-resolution scintigraphy precisely localized degenerative joint disease (nine patients), scaphoid fractures (five), pisiform fracture (one), lunate avascular necrosis (one), radioulnar arthritis (one), septic or inflammatory arthritis (six), ulnocarpal impingement (two), and reflex sympathetic dystrophy syndrome (two). Images obtained palm down with the wrist in ulnar deviation helped identify increased uptake within the scaphoid. Fracture and significant bone or joint disease were excluded in one patient.
在对28例因腕部疼痛接受检查的成年患者中，常规识别腕部的骨性解剖标志（如豌豆骨、钩骨钩、桡尺关节以及桡骨和尺骨茎突）。腕部处于俯卧位并固定，使用不对称（133至161keV）的锝-99m能量窗以及汇聚型（最佳选择）或直孔高分辨率准直器，采集骨闪烁图，计数500,000次。高分辨率闪烁显像精确地定位了退行性关节病（9例患者）、舟骨骨折（5例）、豌豆骨骨折（1例）、月骨缺血性坏死（1例）、桡尺关节炎（1例）、感染性或炎性关节炎（6例）、尺腕撞击症（2例）以及反射性交感神经营养不良综合征（2例）。腕部尺偏、手掌向下时获得的图像有助于识别舟骨内摄取增加的情况。1例患者排除了骨折以及明显的骨或关节疾病。
