Holder L E, Schwarz C, Wernicke P G, Michael R H
Department of Nuclear Medicine, Union Memorial Hospital, Baltimore, MD 21218.
Radiology. 1990 Feb;174(2):509-15. doi: 10.1148/radiology.174.2.2404320.
The results of 179 radionuclide bone imaging examinations, 105 gathered retrospectively from the cases of 97 patients referred for assessment of possible occult fracture of the proximal femur (hip) and 74 performed prospectively on 63 patients referred with a diagnosis of obvious or suspected hip fracture, were analyzed in relation to patient age, the interval between injury and imaging, and the type of fracture sustained. Ninety-two examinations were performed less than 72 hours after injury; 31 of these were done at 0-24 hours. For the diagnosis of hip fracture in an individual patient, the overall sensitivity was 0.933; specificity, 0.950; positive predictive value, 0.918; and negative predictive value, 0.960. For the clinically important subgroup of 145 patients with normal or equivocal radiographs, the sensitivity was 0.978. A characteristic pattern for greater trochanter fractures was found. Other diagnoses were scintigraphically established in 41% of patients evaluated. The data suggest that patients of all ages, regardless of the time after injury, can be imaged as soon as they present.
对179例放射性核素骨显像检查结果进行了分析，其中105例是从97例因评估股骨近端（髋部）可能存在隐匿性骨折而转诊的患者病例中回顾性收集的，74例是对63例诊断为明显或疑似髋部骨折的转诊患者进行前瞻性检查的结果，分析内容涉及患者年龄、受伤与显像之间的时间间隔以及所遭受骨折的类型。92例检查是在受伤后72小时内进行的；其中31例是在0 - 24小时进行的。对于个体患者髋部骨折的诊断，总体敏感性为0.933；特异性为0.950；阳性预测值为0.918；阴性预测值为0.960。对于145例X线片正常或不明确的具有临床重要意义的亚组患者，敏感性为0.978。发现了大转子骨折的特征性模式。在41%接受评估的患者中通过骨闪烁显像确定了其他诊断。数据表明，所有年龄段的患者，无论受伤后时间如何，一经就诊即可进行显像检查。
