Ryan P J, Reddy K, Fleetcroft J
Department of Orthopaedics, Alexandra Hospital, Walderslade, Kent, United Kingdom.
Clin Nucl Med. 1998 Dec;23(12):803-6. doi: 10.1097/00003072-199812000-00002.
Recent studies have shown that SPECT bone scintigraphy is valuable to detect meniscal tears of the knee. This has not been formally assessed in a prospective study, and no substantive study has compared bone SPECT with other noninvasive diagnostic methods. One hundred consecutive patients referred to an orthopedic surgeon with undiagnosed knee pain were assessed by clinical examination, MRI, SPECT bone scintigraphy, and arthroscopy. The MRI and SPECT bone scan findings were reported blinded to other information. Using arthroscopy as a gold standard, both MRI and SPECT showed high diagnostic ability to detect meniscal tears, with respective sensitivity rate, specificity rates, and positive and negative predictive accuracies of 80%, 71%, 84%, and 71% for MRI and 84%, 80%, 88%, and 76% for SPECT. Some meniscal tears were detected by MRI alone (n = 5) or SPECT alone (n = 8). SPECT bone scintigraphy is a suitable alternative to MRI to detect meniscal tears. The comparable diagnostic ability of SPECT bone scintigraphy implies that it can be used successfully when MRI is unavailable or unsuitable.
近期研究表明，单光子发射计算机断层扫描（SPECT）骨闪烁显像对于检测膝关节半月板撕裂很有价值。这一点尚未在前瞻性研究中得到正式评估，且尚无实质性研究将骨SPECT与其他非侵入性诊断方法进行比较。连续100例因膝关节疼痛未确诊而转诊至骨科医生处的患者接受了临床检查、磁共振成像（MRI）、SPECT骨闪烁显像及关节镜检查。MRI和SPECT骨扫描结果的报告不了解其他信息。以关节镜检查作为金标准，MRI和SPECT检测半月板撕裂均显示出较高的诊断能力，MRI的灵敏度、特异度、阳性预测准确率和阴性预测准确率分别为80%、71%、84%和71%，SPECT分别为84%、80%、88%和76%。部分半月板撕裂仅通过MRI（n = 5）或仅通过SPECT（n = 8）检测到。SPECT骨闪烁显像在检测半月板撕裂方面是MRI的合适替代方法。SPECT骨闪烁显像相当的诊断能力意味着在无法获得或不适合使用MRI时，它可以成功应用。
