Collier B D, Carrera G F, Johnson R P, Isitman A T, Hellman R S, Knobel J, Finger W A, Gonyo J E, Malloy P J
J Nucl Med. 1985 Sep;26(9):979-87.
Twenty-one adult patients with the clinical diagnosis of avascular necrosis (AVN) of the femoral head were examined with radionuclide angiography, planar bone scintigraphy, and single photon emission computed tomography (SPECT). A final diagnosis of AVN was established for 15 symptomatic patients with a total of 20 involved hips. SPECT and planar bone scintigraphy were considered positive for AVN only if a photopenic bony defect could be identified. Using SPECT bone scintigraphy, 12 of 15 symptomatic patients and 17 of 20 involved hips (sensitivity of 0.85) were correctly identified, whereas with planar imaging only eight of 15 patients and 11 of 20 involved hips were detected. There were no false-positive diagnoses on SPECT or planar bone scintigraphy. In addition, hyperemia in the region of the proximal femoral metaphysis was demonstrated in six of 20 involved hips. It is concluded that by identifying a photopenic defect that is not evident on planar views, SPECT can contribute to the diagnosis of AVN of the femoral head. In addition, metaphyseal hyperemia appears to be a promising new scintigraphic sign of AVN worthy of further investigation.
对21例临床诊断为股骨头缺血性坏死（AVN）的成年患者进行了放射性核素血管造影、平面骨闪烁显像及单光子发射计算机断层扫描（SPECT）检查。对15例有症状的患者共20个受累髋关节最终确诊为AVN。仅当能识别出放射性缺损性骨缺损时，SPECT和平面骨闪烁显像才被认为对AVN呈阳性。采用SPECT骨闪烁显像，15例有症状患者中的12例以及20个受累髋关节中的17个（敏感性为0.85）被正确识别，而采用平面显像时，15例患者中仅检测出8例，20个受累髋关节中仅检测出11个。SPECT或平面骨闪烁显像均未出现假阳性诊断。此外，20个受累髋关节中的6个显示股骨近端干骺端区域有充血。结论是，通过识别平面显像上不明显的放射性缺损，SPECT有助于股骨头缺血性坏死的诊断。此外，干骺端充血似乎是一种有前景的AVN新闪烁显像征象，值得进一步研究。
