Gillen A, Dyson S, Murray R
Centre for Equine Studies, Animal Health Trust, Lanwades Park, Kentford, Newmarket, Suffolk CB8 7UU, UK.
Equine Vet J. 2009 Jul;41(6):534-40. doi: 10.2746/042516409x376940.
The results of nuclear scintigraphic examination of the thoracolumbar synovial intervertebral articulations (facet joints) have to date been poorly documented.
To establish an objective scintigraphic grading system for the facet joints; to investigate the relationship between the presence or absence of clinical signs of back pain and increased radiopharmaceutical uptake (IRU); and to compare the results of scintigraphy and radiography.
Nuclear scintigraphic images of the 13th thoracic (T13) to first lumbar (L1) vertebrae were graded subjectively (visual assessment of the image) and objectively (using region of interest analysis) from 31 clinically normal horses in full work (Group N) and 65 horses with clinical evidence of thoracolumbar region pain and osteoarthritis of > or = 1 facet joint (Group B). Sensitivity and specificity of IRU for detection of back pain and radiographic abnormalities were assessed. A Spearman correlation was performed to test for an association between the grade of IRU and the classification of radiographic abnormality.
The objective scintigraphic grades were matched by 96.7% of subjective grades. IRU was seen more commonly in Group B (61.5%) than in Group N (25.8%), and moderate or intense IRU was only seen in Group B. The strongest association between radiographic abnormalities and scintigraphy was seen in horses with intense IRU.
Moderate or intense IRU in a facet joint is more likely to be seen in horses with back pain than in clinically normal horses.
Nuclear scintigraphy is a potentially useful tool in the evaluation of a horse with thoracolumbar region pain.
迄今为止，胸腰椎滑膜椎间关节（小关节）的核素闪烁显像检查结果记录较少。
建立小关节的客观闪烁显像分级系统；研究背痛临床体征的有无与放射性药物摄取增加（IRU）之间的关系；比较闪烁显像与X线摄影的结果。
对31匹工作状态良好的临床正常马匹（N组）和65匹有胸腰椎区域疼痛及一个或以上小关节骨关节炎临床证据的马匹（B组）的第13胸椎（T13）至第1腰椎（L1）椎体进行核素闪烁显像，通过主观（图像视觉评估）和客观（使用感兴趣区分析）方法进行分级。评估IRU检测背痛和X线异常的敏感性和特异性。采用Spearman相关性分析来检验IRU分级与X线异常分类之间的关联。
96.7%的主观分级与客观闪烁显像分级相符。IRU在B组（61.5%）比N组（25.8%）更常见，且中度或强烈IRU仅见于B组。在强烈IRU的马匹中，X线异常与闪烁显像之间的关联最强。
与临床正常马匹相比，背痛马匹的小关节更可能出现中度或强烈IRU。
核素闪烁显像在评估胸腰椎区域疼痛的马匹中可能是一种有用的工具。
