Ballani Nasser S, Al-Huda Fawaz Abu, Khan Haider A, Al-Mohannadi Shihab, Mahmood Hanan, Al-Enezi Farha
Biomedical Sciences, Lebanese International University, Beirut, Lebanon.
J Nucl Med Technol. 2007 Jun;35(2):91-5. doi: 10.2967/jnmt.106.035402. Epub 2007 May 11.
Our objective in this study was to evaluate whether measurement of quantitative uptake of (99m)Tc-methylene diphosphate (MDP) and (99m)Tc-hexamethylpropyleneamine oxime (HMPAO) white blood cells (WBCs) is useful in detecting osteomyelitis in peripheral bony lesions.
Twenty-four patients (12 men and 12 women; age range, 25-72 y) were referred for imaging because of clinically suspected osteomyelitis. They had a traumatic fracture (n = 10), knee prosthesis (n = 5), hip prosthesis (n = 2), diabetic foot (n = 4), or chronic osteomyelitis (n = 3). Three-phase bone scanning and (99m)Tc-HMPAO WBC studies were performed on all patients within the same week. Regions of interest were drawn over the abnormal bony sites and the contralateral normal sites, and the abnormal-to-normal uptake ratios (A/N ratios) were obtained for both studies.
All patients had abnormal findings on 3-phase bone scanning, whereas 17 (71%) had abnormal findings on (99m)Tc-HMPAO WBC studies, of which 15 were confirmed to be true-positive. In those 15 patients, the mean A/N ratios for (99m)Tc-MDP and (99m)Tc-HMPAO WBC were 3.0 +/- 1.6 (range, 1.3-6.2) and 1.8 +/- 0.3 (range, 1.4-2.2), respectively. In the other 9 patients, whose scan results were clinically confirmed to be true-negative, the mean A/N ratios for (99m)Tc-MDP and (99m)Tc-HMPAO WBC were 2.1 +/- 1.2 and 1.2 +/- 0.2, respectively. In the group with a (99m)Tc-MDP A/N ratio greater than 2 (n = 15), 87% (13/15) had a high (99m)Tc-HMPAO WBC A/N ratio (>1.5), including 2 that were false-positive. In the remaining 2 patients, one with chronic osteomyelitis and the other with a recent hip prosthesis, (99m)Tc-HMPAO WBC ratios were normal. In the group with a bone A/N ratio of less than 2 (n = 9), only 4 patients (44%) were true-positive for acute osteomyelitis.
(99m)Tc-MDP bone scanning alone, with an A/N ratio of more than 2, is useful in detecting osteomyelitis in violated bone except in the case of a recent hip prosthesis or chronic osteomyelitis.
本研究的目的是评估测量（99m）锝-亚甲基二膦酸盐（MDP）和（99m）锝-六甲基丙烯胺肟（HMPAO）白细胞（WBC）的定量摄取是否有助于检测周围骨病变中的骨髓炎。
24例患者（12例男性和12例女性；年龄范围25 - 72岁）因临床怀疑骨髓炎而接受影像学检查。他们有创伤性骨折（n = 10）、膝关节假体（n = 5）、髋关节假体（n = 2）、糖尿病足（n = 4）或慢性骨髓炎（n = 3）。在同一周内对所有患者进行三相骨扫描和（99m）Tc - HMPAO白细胞研究。在异常骨部位和对侧正常部位绘制感兴趣区域，并获得两项研究的异常与正常摄取比值（A/N比值）。
所有患者三相骨扫描均有异常发现，而17例（71%）（99m）Tc - HMPAO白细胞研究有异常发现，其中15例被确认为真阳性。在这15例患者中，（99m）Tc - MDP和（99m）Tc - HMPAO白细胞的平均A/N比值分别为3.0±1.6（范围1.3 - 6.2）和1.8±0.3（范围1.4 - 2.2）。在其他9例扫描结果经临床确认为真阴性的患者中，（99m）Tc - MDP和（99m）Tc - HMPAO白细胞的平均A/N比值分别为2.1±1.2和1.2±0.2。在（99m）Tc - MDP A/N比值大于2的组（n = 15）中，87%（13/1
