López B Diego Fernando, Corral S Claudia Marcela
Universidad del Valle, Cali, Colombia.
J Craniomaxillofac Surg. 2016 Jan;44(1):70-4. doi: 10.1016/j.jcms.2015.10.026. Epub 2015 Oct 31.
The aim of this study was to compare the reliability and correlations with age and gender of two nuclear medicine tests used for diagnosis of active condylar hyperplasia, namely, planar bone scintigraphy versus single photon emission computed tomography (SPECT).
This was a descriptive observational study carried out in 61 patients (38 women and 23 men) clinically diagnosed as having facial asymmetry and suspected unilateral condylar hyperplasia. The patients had both planar bone scintigraphy and SPECT diagnostic imaging as well as reference data of the percentage of (99)Tc(m) MDP (methylenediphosphonate) uptake in the condyle, clivus, and fourth lumbar vertebra (L4), respectively, for SPECT and planar scintigraphy calculations. Radioactive counts were measured per region of interest and the respective ratios were calculated. The age range of the patients was 13-50 years (mean ± standard deviation = 21.16 ± 8.75). The two groups were compared by a nonparametric (Mann-Whitney U test. Uptake percentage and delta values had normal distribution and consequently were compared by a Student t test.
A total of 61 anterior planar images and 61 SPECT images were compared. Eight patients presented high uptake in planar bone scintigraphy images (13.11%), while 32 patients (52.46%) had high uptake with SPECT. The prevalence of condylar hyperactivity was higher in women than in men both for right condyle (ratio 4:3) and for left condyle (10:1) and the prevalence was significantly higher for the right condyle.
The study indicates that SPECT is more sensitive to identify condylar hyperactivity as compared to planar bone scintigraphy in patients with clinical presumptive diagnostic of condylar hyperplasia.
本研究旨在比较用于诊断活跃性髁突增生的两种核医学检查（即平面骨闪烁显像与单光子发射计算机断层扫描（SPECT））的可靠性以及与年龄和性别的相关性。
这是一项描述性观察性研究，对61例临床诊断为面部不对称且疑似单侧髁突增生的患者（38名女性和23名男性）进行。患者接受了平面骨闪烁显像和SPECT诊断成像，以及分别用于SPECT和平面闪烁显像计算的髁突、斜坡和第四腰椎（L4）的（99）Tc（m）亚甲基二膦酸盐（MDP）摄取百分比的参考数据。在每个感兴趣区域测量放射性计数并计算各自的比值。患者的年龄范围为13至50岁（平均±标准差=21.16±8.75）。两组通过非参数（曼-惠特尼U检验）进行比较。摄取百分比和差值具有正态分布，并因此通过学生t检验进行比较。
共比较了61张前位平面图像和61张SPECT图像。8例患者在平面骨闪烁显像图像中表现为高摄取（13.11%），而32例患者（52.46%）在SPECT检查中表现为高摄取。无论是右侧髁突（比例为4:3）还是左侧髁突（10:1），女性髁突活动亢进的患病率均高于男性，且右侧髁突的患病率显著更高。
该研究表明，在临床疑似诊断为髁突增生的患者中，与平面骨闪烁显像相比，SPECT在识别髁突活动亢进方面更敏感。
