[锝]亚甲基二膦酸盐单光子发射计算机断层扫描/计算机断层扫描（[Tc]MDP SPECT/CT）半定量分析在对磁共振成像（MRI）有禁忌证的疑似新鲜骨质疏松性椎体压缩骨折患者中定位责任病灶的价值。

The value of semiquantitative analysis of [Tc]MDP SPECT/CT in localizing responsible lesions for suspected fresh osteoporotic vertebral compression fractures in patients with contraindications to MRI.

作者信息

Shi Sheng, Cai Hai-Dong, Lu Gai-Xia, Zhang Li-Guo, Zheng Shuang, He Shi-Sheng

机构信息

Department of Orthopaedics, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China.

Spinal Pain Research Institute, School of Medicine, Tongji University, Shanghai, China.

出版信息

Clin Physiol Funct Imaging. 2025 Jan;45(1):e12923. doi: 10.1111/cpf.12923.

DOI:10.1111/cpf.12923

PMID:39726061

Abstract

PURPOSE

The aim of this study was to evaluate the effectiveness of single-photon emission computed tomography/computed tomography (SPECT/CT) in detecting and localizing the causative vertebra in cases of suspected fresh osteoporotic vertebral compression fractures (OVCFs) in patients with contraindications to MRI.

METHODS

A total of 21 patients with severe back pain with 31 suspected OVCF segments and contraindications to MRI were initially identified through radiographs and the back pain-inducing test (BPIT). The responsible vertebral bodies were determined using [Tc]MDP SPECT/CT before percutaneous vertebroplasty (PVP). Clinical outcomes and radiographic parameters, including basic demographics, injury duration, focal kyphosis (FK), loss of vertebral height (LVH), and relative intensity values (RIVs) for target and nontarget segments in the SPECT/CT were measured.

RESULTS

SPECT/CT identified 14 old and 26 fresh OVCFs. Of these, 18 patients with 26 fresh OVCF segments underwent PVP, and achieved satisfactory outcomes. Significant differences were observed in the RIV, FK, and LVH values between the fresh and old OCVF groups (all p < 0.05). RIVs showed a significant negative correlation with injury duration (r = -0.57, p < 0.05), and a positive correlation with LVH (r = 0.43, p < 0.05). Multiple linear regression analysis confirmed that injury duration was an independent predictor of RIVs (p < 0.05).

CONCLUSION

SPECT/CT is useful for detecting and differentiating fresh fractures from old fractures in patients having OVCF who cannot undergo MRI after BPIT validation, allowing these patients to achieve excellent clinical outcomes following PVP. The RIV serves as a valuable parameter for assessing the duration of fresh versus old OVCFs.

TRIAL REGISTRATION

ChiCTR, ChiCTR 2300077570. Retrospectively registered, http://www.chictr.org.cn/showproj.html?proj=206192.

摘要

目的

本研究旨在评估单光子发射计算机断层扫描/计算机断层扫描（SPECT/CT）在检测和定位有MRI检查禁忌证的疑似新鲜骨质疏松性椎体压缩骨折（OVCF）患者的责任椎体方面的有效性。

方法

最初通过X线片和背痛诱发试验（BPIT）确定了21例有严重背痛且有31个疑似OVCF节段并有MRI检查禁忌证的患者。在经皮椎体成形术（PVP）前，使用[Tc]MDP SPECT/CT确定责任椎体。测量临床结果和影像学参数，包括基本人口统计学数据、损伤持续时间、局部后凸（FK）、椎体高度丢失（LVH）以及SPECT/CT中目标节段和非目标节段的相对强度值（RIV）。

结果

SPECT/CT识别出14例陈旧性和26例新鲜OVCF。其中，18例有26个新鲜OVCF节段的患者接受了PVP，并取得了满意的结果。新鲜和陈旧OVCF组之间的RIV、FK和LVH值存在显著差异（均p<0.05）。RIV与损伤持续时间呈显著负相关（r=-0.57，p<0.05），与LVH呈正相关（r=0.43，p<0.05）。多元线性回归分析证实损伤持续时间是RIV的独立预测因素（p<0.05）。