al-Rowaih A, Wingstrand H, Lindstrand A, Björkengren A, Thorngren K G, Gustafson T
Department of Orthopedics, Lund University, Sweden.
Acta Orthop Scand. 1990 Apr;61(2):120-7. doi: 10.3109/17453679009006502.
Three-phase scintimetry with 99mTc MDP was analyzed in 40 patients with a clinical history of spontaneous onset of knee pain and a focal static isotope uptake in the femoral condyle indicating osteonecrosis. A strong correlation was found between pool-phase ratios and the static ratios. The pool-phase study did not add to the information obtained from the flow phase and static studies. There was a characteristic change of the pattern of the early flow-phase curves with the duration since the onset of symptoms indicating hyperemia early in the disease. A persistent high flow-phase and static-uptake ratio 6-12 months after the onset of symptoms correlated positively with a poor clinical and radiographic outcome. The 10 patients with a good prognosis had, as a group, a more rapid decrease in isotope uptake after 6 months. There was a positive correlation between a high static uptake ratio and the size of the lesion, and subsequently with the clinical and radiographic outcome. 30 patients developed arthrosis and/or severe clinical symptoms. Five of the 10 patients who did not develop arthrosis never developed radiographic evidence of osteonecrosis.
对40例有膝关节疼痛自发发作病史且股骨髁有局灶性静态同位素摄取提示骨坏死的患者进行了99mTc MDP三相闪烁扫描分析。发现血池相比值与静态比值之间有很强的相关性。血池相研究并未增加从血流相和静态研究中获得的信息。随着症状出现后的病程，早期血流相曲线模式有特征性变化，提示疾病早期存在充血。症状出现后6 - 12个月持续的高血流相和静态摄取比值与不良的临床和影像学结果呈正相关。10例预后良好的患者作为一个整体，6个月后同位素摄取下降更快。高静态摄取比值与病变大小之间存在正相关，进而与临床和影像学结果相关。30例患者出现了关节病和/或严重的临床症状。10例未发生关节病的患者中有5例从未出现骨坏死的影像学证据。
