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儿童背痛与（99m）锝亚甲基二膦酸盐骨闪烁显像的诊断价值

Back Pain in Children and Diagnostic Value of (99m)Tc MDP Bone Scintigraphy.

作者信息

Alkhawaldeh Khaled, Ghuweri Ali Al, Kawar Jane, Jaafreh Amany

机构信息

Department. King Hussein Medical Center. Royal Medical Services. Amman, Jordan.

出版信息

Acta Inform Med. 2014 Oct;22(5):297-301. doi: 10.5455/aim.2014.22.297-301. Epub 2014 Oct 29.

DOI:10.5455/aim.2014.22.297-301
PMID:25568576
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4272846/
Abstract

AIM

The aim of our study is to assess the diagnostic value of Technituim-(99m)-Methyle diphosphonate ((99m)Tc-MDP) Bone scintigraphy in the assessment of children with back pain.

METHODS

Included in this retrospective study were 68 child referred to us complaining of back pain (mean age of 13+ 2). There were 45 boys and 23 girls. All children have been investigated with conventional x-ray which revealed normal or inconclusive result. All underwent bone scintigraphy after the injection of (99m)Tc-MDP with calculated doses according to there body weights.

RESULTS

Bone scintigraphy revealed 17 (25%) abnormal scans in 11 boys and 6 girls. Scans findings were suggestive of spondylolysis (n=4); malignancy including primary tumors and metastases (n=3); infection including osteomyelitis and discitis (n=3); sacroiliitis (n=2); benign tumors (n=2); pseudo fractures in ribs (n=1); necrosis in femoral head epiphysis(n=1) and nonskeletal-renal retention due to hydronephrosis (n=1). Sensitivity, specificity and accuracy of bone scan in detecting gross skeletal abnormality as a cause for back pain were 94% and 100% and 99% respectively.

CONCLUSION

Bone isotope scan is a sensitive imaging modality in the assessment of pediatric patients with back pain. It is a reliable modality to detect and role out most benign and aggressive serious etiologies.

摘要

目的

本研究旨在评估锝-（99m）-亚甲基二膦酸盐（（99m）Tc-MDP）骨闪烁显像在评估背痛儿童中的诊断价值。

方法

本回顾性研究纳入了68例因背痛前来就诊的儿童（平均年龄13±2岁）。其中男孩45例，女孩23例。所有儿童均接受了传统X线检查，结果显示正常或不明确。所有儿童在注射（99m）Tc-MDP后均接受了骨闪烁显像，根据体重计算剂量。

结果

骨闪烁显像显示11例男孩和6例女孩中有17例（25%）扫描异常。扫描结果提示椎弓根峡部裂（n = 4）；恶性肿瘤，包括原发性肿瘤和转移瘤（n = 3）；感染，包括骨髓炎和椎间盘炎（n = 3）；骶髂关节炎（n = 2）；良性肿瘤（n = 2）；肋骨假骨折（n = 1）；股骨头骨骺坏死（n = 1）以及因肾积水导致的非骨骼-肾脏放射性滞留（n = 1）。骨扫描检测作为背痛原因的明显骨骼异常的敏感性、特异性和准确性分别为94%、100%和99%。

结论

骨同位素扫描是评估背痛儿科患者时一种敏感的成像方式。它是检测和排除大多数良性和侵袭性严重病因的可靠方式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62d5/4272846/cdc608527a76/AIM-22-297-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62d5/4272846/78ac1f4b1e95/AIM-22-297-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62d5/4272846/750ed4b2aa0d/AIM-22-297-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62d5/4272846/1820ece442f5/AIM-22-297-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62d5/4272846/3bec374de245/AIM-22-297-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62d5/4272846/94b2eb7ac6a7/AIM-22-297-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62d5/4272846/cdc608527a76/AIM-22-297-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62d5/4272846/78ac1f4b1e95/AIM-22-297-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62d5/4272846/750ed4b2aa0d/AIM-22-297-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62d5/4272846/1820ece442f5/AIM-22-297-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62d5/4272846/3bec374de245/AIM-22-297-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62d5/4272846/94b2eb7ac6a7/AIM-22-297-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62d5/4272846/cdc608527a76/AIM-22-297-g008.jpg

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