Gelfand M J, Daya S A, Rucknagel D L, Kalinyak K A, Paltiel H J
Department of Radiology, Children's Hospital Medical Center, Cincinnati, Ohio 45229-2899.
J Nucl Med. 1993 Apr;34(4):614-8.
In order to determine if a relationship exists between rib infarction and the acute chest syndrome (ACS) in sickle cell disease patients, bone scans were reviewed in 55 episodes in 38 patients with pain of suspected osseous origin. A bone scan was positive for thoracic bone infarction if abnormally increased or decreased uptake was present in ribs, sternum or thoracic spine. Radiographs were considered to be positive for ACS if there was pulmonary infiltrate or pleural effusion in the absence of laboratory or clinical evidence of bacterial pneumonia. ACS by chest x-ray was present in 22 episodes, 21 of which showed evidence of infarction of the bony thorax on bone scan. Thoracic bone infarction occurred in the absence of chest x-ray changes in only 11 episodes. This association between bone infarction and radiographic ACS was statistically significant (p < 0.001, Fisher's exact test). A strong association exists between ACS and infarction of the bony thorax. It is possible that bone infarction leads to pain, hypoventilation and the clinical picture of ACS.
为了确定镰状细胞病患者的肋骨梗死与急性胸综合征（ACS）之间是否存在关联，我们回顾了38例疑似骨源性疼痛患者的55次骨扫描情况。如果肋骨、胸骨或胸椎出现异常的摄取增加或减少，则骨扫描显示胸椎骨梗死呈阳性。如果在没有细菌性肺炎的实验室或临床证据的情况下出现肺部浸润或胸腔积液，则胸部X光片被认为ACS呈阳性。胸部X光显示ACS的情况有22次，其中21次在骨扫描中显示有胸廓骨梗死的证据。仅11次出现了没有胸部X光变化的胸椎骨梗死情况。骨梗死与放射学ACS之间的这种关联具有统计学意义（p < 0.001，Fisher精确检验）。ACS与胸廓骨梗死之间存在强烈关联。骨梗死可能导致疼痛、通气不足以及ACS的临床表现。
