Amsterdam University Medical Centers, Location AMC, University of Amsterdam, Trauma Unit, Department of Surgery, Amsterdam, The Netherlands.
Amsterdam University Medical Centers, Location AMC, Department of Radiology and Nuclear Medicine, Amsterdam Movement Sciences, Amsterdam, The Netherlands.
Foot Ankle Surg. 2021 Oct;27(7):715-722. doi: 10.1016/j.fas.2020.09.009. Epub 2020 Sep 30.
Foot and ankle injuries are common. Radiographic assessment is difficult because of the complex anatomy. In the past decade SPECT/CT made its introduction in assessing bone pathology, it combines both morphologic and pathologic imaging in one image aiming to increase sensitivity and specificity when compared with MRI or CT alone. The purpose of this review was to provide a literature overview on the diagnostic value of SPECT/CT in foot and ankle pathology.
A literature search was conducted in the databases of PubMed and EMBASE between January 2004 and September 2019 for articles describing the diagnostic value of SPECT/CT in foot and ankle pathology. For assessment of methodological quality of each study included in the analysis, QUADAS-2 checklist was used. Main outcomes were change of management, improved diagnosis and symptomatic improvement.
A total of eight studies were identified describing the diagnostic value of SPECT/CT in foot and ankle pathology based on patient data. The combined analysis shows that change of management and improved diagnosis occurred in 48-62% and 40-79% of the patients when compared with other imaging modalities and/or clinical assessment. Symptomatic improvement due to treatment based on SPECT/CT findings occurred in 92% of the patients.
SPECT/CT is useful when diagnosis based on other imaging modalities is inconclusive or when treatment based on these modalities does not lead to the desired symptomatic improvement.
足部和踝关节损伤很常见。由于解剖结构复杂，影像学评估具有一定难度。过去十年，SPECT/CT 技术在评估骨骼病变方面得到了应用。SPECT/CT 将形态学和病理学成像结合在一幅图像中，与 MRI 或 CT 相比，旨在提高其诊断的灵敏度和特异性。本文旨在提供 SPECT/CT 在足部和踝关节病变中的诊断价值的文献综述。
在 2004 年 1 月至 2019 年 9 月间，我们在 PubMed 和 EMBASE 数据库中进行了文献检索，以检索描述 SPECT/CT 在足部和踝关节病理学中诊断价值的文章。使用 QUADAS-2 清单评估纳入分析的每项研究的方法学质量。主要结果是管理方式的改变、诊断的改善和症状的改善。
共确定了 8 项基于患者数据描述 SPECT/CT 在足部和踝关节病理学中的诊断价值的研究。综合分析显示，与其他影像学检查和/或临床评估相比，SPECT/CT 可使 48%-62%的患者改变治疗方案，使 40%-79%的患者获得改善诊断。基于 SPECT/CT 检查结果进行治疗后，92%的患者症状得到改善。
当基于其他影像学检查的诊断不确定时，或者基于这些检查的治疗未导致预期的症状改善时，SPECT/CT 是有用的。
