利用锝-99m亚甲基二膦酸盐和锝-99m六甲基丙烯胺肟标记白细胞的互补作用诊断骨感染

Diagnosis of bone infection by complementary role of technetium-99m MDP and technetium-99m hexamethylpropylene-amineoxime-leukocytes.

作者信息

Al-Zahrani Abdullah, El-Saban Khaled, Al-Sakhri Hijji

机构信息

Department of Orthopedic, Faculty of Medicine, Taif University, Taif, Saudi Arabia.

出版信息

Indian J Nucl Med. 2012 Jul;27(3):164-71. doi: 10.4103/0972-3919.112721.

DOI:10.4103/0972-3919.112721

PMID:23919069

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3728737/

Abstract

PURPOSE

Valuate complementary role of (99m)Tc-MDP bone scan and (99m)Technetium hexamethylpropylene-amineoxime ((99m)Tc-HMPAO) labeled leukocyte scintigraphy in diagnosis of bone infection.

PATIENTS AND METHODS

NINETY ONE SITES SUSPECTED TO HAVE BONE INFECTION WERE DIVIDED IN TO TWO GROUPS: Group I 49 sites with current endo-prothesis; and group II 42 sites with no prosthesis. All patients were subjected to serial images of (99m)Tc-HMPAO labeled leukocyte ((99m)Tc-white blood cells (WBCs)), triple phase bone scan ((99m)Tc-MDP) and plain X-ray, in addition to clinical and bacteriological assessment, together with follow-up.

RESULTS

The overall sensitivity (Sn) was found to be 34.9%, 95.4%, and 86% for plain X-ray, (99m)Tc-MDP, and (99m)Tc-WBCs respectively. Concerning specificity (Sp) was found to be 47.9%, 45.8%, and 91.7% respectively for the three imaging modalities. (99m)Tc-WBCs showed better Sn, Sp, and accuracy in group I (95%, 93.1% and 93.9%, respectively) compared to 40%, 41.4%, and 40.8% for plain X-ray and 90%, 62%, and 73.5% respectively for (99m)Tc-MDP. On the other hand, (99m)Tc-MDP proved to have best Sn 100% versus 78.3% and 30.4% for (99m)Tc-WBCs and plain X-ray respectively. Yet, Sp and accuracy was found to best for (99m)Tc-WBCs (89.5% and 83.3% respectively) compared to 57.9% and 42.9% for plain X-ray and 21.1% and 64.3% for (99m)Tc-MDP.

CONCLUSION

Combined imaging with (99m)Tc-WBCs and (99m)Tc-MDP proved to be effective in early detection of bone infection in the presence or absence of prosthesis.

摘要

目的

评估（99m）锝亚甲基二膦酸盐（（99m）Tc-MDP）骨扫描和（99m）锝六甲基丙烯胺肟（（99m）Tc-HMPAO）标记白细胞闪烁扫描在骨感染诊断中的互补作用。

患者与方法

91个疑似骨感染部位分为两组：第一组49个部位有当前的内置假体；第二组42个部位无假体。所有患者均接受了（99m）Tc-HMPAO标记白细胞（（99m）Tc-白细胞（WBCs））、三相骨扫描（（99m）Tc-MDP）和X线平片的系列影像检查，此外还进行了临床和细菌学评估以及随访。

结果

X线平片、（99m）Tc-MDP和（99m）Tc-WBCs的总体敏感度（Sn）分别为34.9%、95.4%和86%。三种成像方式的特异度（Sp）分别为47.9%、45.8%和91.7%。与X线平片的40%、41.4%和40.8%以及（99m）Tc-MDP的90%、62%和73.5%相比，（99m）Tc-WBCs在第一组显示出更好的Sn、Sp和准确度（分别为95%、93.1%和93.9%）。另一方面，（99m）Tc-MDP的Sn被证明最佳，为100%，而（99m）Tc-WBCs和X线平片分别为78.3%和30.4%。然而，与X线平片的57.9%和42.9%以及（99m）Tc-MDP的21.1%和64.3%相比，（99m）Tc-WBCs的Sp和准确度最佳（分别为89.5%和83.3%）。