Kim K Y, Lee S H, Moon D H, Nah H Y
Department of Orthopaedic Surgery, University of Ulsan Medical College, Asan Medical Centre, Seoul, Korea.
Int Orthop. 1993;17(3):132-8. doi: 10.1007/BF00186372.
Bone scans, triple head single photon emission computed tomography (3H-SPECT) and MRI scans were compared for their ability to detect avascular necrosis of the femoral head (AVN). 3H-SPECT was undertaken 5 hours after injection of 20 mCi of Tc-99m MDP for 20 minutes using a 3 detector rotating gamma camera (TRIAD, Trionix) equipped with ultra-high resolution collimators. The bone scan and 3H-SPECT were diagnosed as positive for AVN when a photopenic defect in the femoral head could be identified. The final diagnosis of AVN was established in 32 patients in 52 hips by MRI and/or histological findings. Unilateral disease was present in 11 patients, while 21 had bilateral disease. Of 32 patients and 52 hips, the bone scan, 3H-SPECT and MRI detected 37, 46 and 52 positive hips respectively. The sensitivity of 3H-SPECT (88.5%) was higher than that of the bone scans (71.5%), and was also higher than that previously reported using a single head SPECT. In AVN, the 3H-SPECT image was much clearer, and permitted more accurate localization of lesions than was possible by a bone scan. Studies including patients with diseases other than AVN and correlation with other methods of imaging is needed to define the role of 3H-SPECT in the diagnosis of AVN more precisely.
对骨扫描、三头单光子发射计算机断层扫描（3H-SPECT）和磁共振成像（MRI）扫描检测股骨头缺血性坏死（AVN）的能力进行了比较。注射20毫居里的锝-99m亚甲基二膦酸盐（Tc-99m MDP）20分钟后，使用配备超高分辨率准直器的三探测器旋转γ相机（TRIAD，Trionix）进行3H-SPECT检查，检查时间为5小时。当股骨头出现放射性缺损时，骨扫描和3H-SPECT被诊断为AVN阳性。通过MRI和/或组织学检查结果，在52个髋关节的32例患者中确诊为AVN。11例患者为单侧病变，21例为双侧病变。在32例患者和52个髋关节中，骨扫描、3H-SPECT和MRI分别检测到37个、46个和52个阳性髋关节。3H-SPECT的灵敏度（88.5%）高于骨扫描（71.5%），也高于先前使用单头SPECT报道的灵敏度。在AVN中，3H-SPECT图像更清晰，与骨扫描相比，能够更准确地定位病变。需要进行包括非AVN疾病患者的研究以及与其他成像方法的相关性研究，以更精确地确定3H-SPECT在AVN诊断中的作用。
