Dasa Vinod, Adbel-Nabi Hani, Anders Mark J, Mihalko William M
Department of Orthopaedic Surgery, University of Buffalo, Buffalo, NY, USA.
Clin Orthop Relat Res. 2008 May;466(5):1081-6. doi: 10.1007/s11999-008-0219-2. Epub 2008 Mar 24.
Osteonecrosis (ON) of the femoral head continues to be a devastating disorder for young patients. We evaluated the F-18 fluoride positron emission tomography (PET) imaging modality for use in detection of the bone involved in ON of the hip. We retrospectively reviewed the records of 60 consecutive patients diagnosed with ON and interviewed all by phone. Eleven patients (17 hips) of those interviewed agreed to participate in the study. We classified the ON using the University of Pennsylvania classification system and compared each patient's plain AP bone scan, single photon emission 3-D computed tomography, and MRI. ON was associated with HIV, alcohol, steroid use, and polycythemia vera in this group. Nine of 17 hips (8 patients) had acetabular increased uptake when using the F-18 fluoride PET scans that were not seen on MRI, single photon emission computed tomography, or bone scans. These data suggest earlier acetabular changes in osteonecrosis may exist that traditional imaging modalities do not reveal.
股骨头坏死对于年轻患者而言仍然是一种极具破坏性的疾病。我们评估了F-18氟化物正电子发射断层扫描（PET）成像方式在检测髋关节股骨头坏死受累骨骼方面的应用。我们回顾性分析了60例连续诊断为股骨头坏死患者的病历，并通过电话对所有患者进行了访谈。接受访谈的患者中有11例（17髋）同意参与本研究。我们采用宾夕法尼亚大学分类系统对股骨头坏死进行分类，并比较了每位患者的骨盆前后位平片骨扫描、单光子发射三维计算机断层扫描和磁共振成像（MRI）。该组中，股骨头坏死与人类免疫缺陷病毒（HIV）、酒精、类固醇使用及真性红细胞增多症相关。在17髋中的9髋（8例患者），使用F-18氟化物PET扫描时发现髋臼摄取增加，而在MRI、单光子发射计算机断层扫描或骨扫描中未发现此情况。这些数据表明，股骨头坏死中髋臼的早期变化可能存在，而传统成像方式无法显示这些变化。
