Lou Jingjing, Wen Guanghua, Dong Ke, Zhang Yifan
aDepartment of Nuclear Medicine, Jinhua Central Hospital, Jinhua Hospital of Zhejiang University, JinhuabDepartment of Nuclear Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Nucl Med Commun. 2017 Oct;38(10):854-857. doi: 10.1097/MNM.0000000000000726.
The aim of this study was to investigate the effectiveness of a technetium-99m-methylene diphosphonate (Tc-MDP) bone scan and the bone mineral density (BMD) test in monitoring the efficacy of osteoporosis (OP) treatment.
A total of 50 women with OP were prospectively enrolled in this study from January 2011 to October 2016 in our hospital. All the patients underwent a Tc-MDP whole-body bone scan and the BMD test before and after alendronate sodium treatment at 3, 6, 12 and 18 months, respectively. Bone metabolism rate on the Tc-MDP bone scan was analysed and expressed as the region-of-interest (ROI) ratio of target bones (L1-L4 vertebrae and femoral neck) to the control right tibia shaft, which was subsequently compared with the bone mass on BMD test at each time point of the treatment.
The mean ROI ratio of the L1 vertebra on the Tc-MDP bone scans decreased significantly starting at 3 months and continued to decrease at 6, 12 and 18 months, respectively (P<0.001). The mean ROI ratio decreased significantly starting at 6 months at the L2 (P<0.001) and L3 (P<0.001) and starting at 12 months at the L4 (P<0.001) and the right femoral head (P<0.001), respectively. In contrast, the BMD levels of the L1, L2, L3 and L4 vertebrae and the femoral neck increased significantly after 12, 12, 18, 18 and 18 months alendronate treatment respectively.
Tc-MDP bone scan can detect the alendronate therapeutic efficacy for OP much earlier than the BMD test.
本研究旨在探讨锝-99m-亚甲基二膦酸盐（Tc-MDP）骨扫描及骨密度（BMD）检测在监测骨质疏松症（OP）治疗效果中的有效性。
2011年1月至2016年10月，我院前瞻性纳入了50例OP女性患者。所有患者在阿仑膦酸钠治疗前及治疗后3、6、12和18个月分别接受Tc-MDP全身骨扫描及BMD检测。分析Tc-MDP骨扫描上的骨代谢率，并将其表示为目标骨（L1-L4椎体和股骨颈）与对照右侧胫骨干的感兴趣区（ROI）比值，随后将其与治疗各时间点BMD检测的骨量进行比较。
Tc-MDP骨扫描上L1椎体的平均ROI比值从3个月开始显著下降，并在6、12和18个月时持续下降（P<0.001）。L2（P<0.001）和L3（P<0.001）的平均ROI比值分别从6个月开始显著下降，L4（P<0.001）和右股骨头（P<0.001）的平均ROI比值分别从12个月开始显著下降。相比之下，阿仑膦酸钠治疗12、12、18、18和18个月后，L1、L2、L3和L4椎体以及股骨颈的BMD水平分别显著升高。
Tc-MDP骨扫描比BMD检测能更早地检测到阿仑膦酸钠对OP的治疗效果。
