颅骨骨髓炎：采用铟 - 111 白细胞和锝 - 99m 亚甲基二膦酸盐骨 SPECT、CT 及 MR 成像进行诊断与随访
Cranial osteomyelitis: diagnosis and follow-up with In-111 white blood cell and Tc-99m methylene diphosphonate bone SPECT, CT, and MR imaging.
作者信息
Seabold J E, Simonson T M, Weber P C, Thompson B H, Harris K G, Rezai K, Madsen M T, Hoffman H T
机构信息
Department of Radiology, University of Iowa College of Medicine, Iowa City, USA.
出版信息
Radiology. 1995 Sep;196(3):779-88. doi: 10.1148/radiology.196.3.7644643.
PURPOSE
To assess the usefulness of indium-111 white blood cell and technetium-99m methylene diphosphonate bone single photon emission computed tomography (SPECT), computed tomography (CT), and magnetic resonance (MR) imaging in cranial osteomyelitis.
MATERIALS AND METHODS
Twenty-six cases (25 patients: 13 male, 12 female; mean age, 55 years) of suspected osteomyelitis were evaluated. Sixteen were postoperative. Final diagnosis was established by means of bone culture in 18 cases and clinical follow-up in eight.
RESULTS
Of 35 CT scans, 10 were true-positive (TP); three false-negative (FN); 13, true-negative (TN); one, false-positive (FP); and eight, equivocal. Of 36 SPECT scans, 19 were TP; 13, TN; one, FP; one, FN; and two, equivocal. Of 11 MR images four were TP; five, TN; and two, FN.
CONCLUSION
CT is best for differentiation between soft-tissue and bone infection. MR imaging is best for assessment of the calvaria and skull base. SPECT is best for assessment of altered bone and may be the best technique for follow-up.
目的
评估铟 - 111 白细胞和锝 - 99m 亚甲基二膦酸盐骨单光子发射计算机断层扫描（SPECT）、计算机断层扫描（CT）及磁共振成像（MR）在颅骨骨髓炎中的应用价值。
材料与方法
对 26 例（25 名患者：男性 13 例，女性 12 例；平均年龄 55 岁）疑似骨髓炎患者进行评估。其中 16 例为术后患者。最终诊断 18 例通过骨培养确定，8 例通过临床随访确定。
结果
35 次 CT 扫描中，10 次为真阳性（TP）；3 次为假阴性（FN）；13 次为真阴性（TN）；1 次为假阳性（FP）；8 次结果不明确。36 次 SPECT 扫描中，19 次为 TP；13 次为 TN；1 次为 FP；1 次为 FN；2 次结果不明确。11 次 MR 成像中，4 次为 TP；5 次为 TN；2 次为 FN。
结论
CT 最有助于区分软组织感染和骨感染。MR成像最有助于评估颅盖骨和颅底。SPECT 最有助于评估骨质改变，可能是随访的最佳技术。
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