利用术前骨闪烁显像摄取情况预测股骨头坏死患者髂骨骨髓采集成功率：一项横断面研究
Predicting iliac bone marrow harvest success in osteonecrosis of femoral head using preoperative bone scintigraphy uptake: a cross sectional study.
作者信息
Tomaru Yohei, Homma Yasuhiro, Hernigou Philippe, Yoshioka Tomokazu, Sugaya Hisashi, Tsukagoshi Yuta, Kamada Hiroshi, Mishima Hajime
机构信息
Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
出版信息
BMC Musculoskelet Disord. 2025 Jun 5;26(1):564. doi: 10.1186/s12891-025-08819-1.
BACKGROUND
Bone marrow transplantation has been employed as a regenerative treatment for osteonecrosis of the femoral head (ONFH). However, in clinical practice, obtaining a sufficient volume of bone marrow aspirate under general anesthesia can sometimes be challenging. Currently, there is no established method to predict the quantity and quality of bone marrow that can be harvested preoperatively. We hypothesized that these parameters could be inferred from preoperative bone scintigraphy uptake. Therefore, this study aims to investigate the relationship between bone marrow quantity and quality and the uptake observed on preoperative bone scintigraphy.
METHODS
This retrospective study included 145 consecutive patients with ONFH who underwent bone marrow transplantation between 2009 and 2014. The edges of the ilium were manually delineated on the images obtained by combining bone scintigraphy and computed tomography. The average pixel value within this delineated area was calculated. We analyzed correlations between the average pixel value on bone scintigraphy for both ilium and the quantity of bone marrow collected from the ilium, as well as the CFU-Fs obtained from 600μl of concentrated bone marrow.
RESULTS
Sixty-two patients were excluded due to insufficient data on bone scintigraphy and colony-forming unit of fibroblasts (CFU-Fs), leaving 83 patients for final analysis. The mean bone marrow quantity, CFU-Fs per 600μl, and the pixel value of bone scintigraphy were 227 ml (range, 6-400), 42 (range, 4-200), and 109 (range, 28-730), respectively. A significant correlation was found between the pixel value and bone marrow quantity (Pearson's correlation coefficient, r = 0.24, p < 0.05), while no significant relationship was observed with CFU-Fs.
CONCLUSIONS
Patients with low bone scintigraphy uptake require careful consideration as an adequate amount of bone marrow may not be obtainable.
背景
骨髓移植已被用作股骨头坏死（ONFH）的一种再生治疗方法。然而，在临床实践中，在全身麻醉下获取足够量的骨髓抽吸物有时具有挑战性。目前，尚无术前预测可采集骨髓数量和质量的既定方法。我们推测这些参数可从术前骨闪烁显像摄取情况推断得出。因此，本研究旨在探讨骨髓数量和质量与术前骨闪烁显像观察到的摄取情况之间的关系。
方法
这项回顾性研究纳入了2009年至2014年间连续接受骨髓移植的145例ONFH患者。通过结合骨闪烁显像和计算机断层扫描获得的图像上，手动勾勒出髂骨边缘。计算该勾勒区域内的平均像素值。我们分析了双侧髂骨骨闪烁显像的平均像素值与从髂骨采集的骨髓量以及从600μl浓缩骨髓中获得的集落形成单位成纤维细胞（CFU-Fs）之间的相关性。
结果
由于骨闪烁显像和成纤维细胞集落形成单位（CFU-Fs）数据不足，62例患者被排除，最终83例患者纳入分析。平均骨髓量、每600μl的CFU-Fs以及骨闪烁显像的像素值分别为227ml（范围6 - 400）、42（范围4 - 200）和109（范围28 - 730）。像素值与骨髓量之间存在显著相关性（Pearson相关系数，r = 0.24，p < 0.05），而与CFU-Fs未观察到显著关系。
结论
骨闪烁显像摄取低的患者需要仔细考虑，因为可能无法获得足够量的骨髓。
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