~(99)Tc~m-Citrate及其半定量分析对急性化脓性骨关节炎诊断价值的研究

目的:研究99Tcm-Citrate(枸橼酸)显像对急性化脓性骨关节炎的临床诊断价值。方法:急性化脓性骨关节炎患者17例和非化脓性骨关节病患者19例分别行99Tcm-MDP显像和99Tcm-Citrate显像,并进行半定量分析。结果:在急性化脓性骨关节炎病灶处99Tcm-Citrate显像有明显趋骨性浓集;而非化脓性骨关节疾病病灶处99Tcm-Citrate显像仅有轻度的趋骨性浓集。半定量分析示99Tcm-Citrate显像在急性化脓性骨关节炎放射性靶与非靶组织比值(L/N=2.300±0.094)明显高于非化脓性骨关节病放射性靶与非靶组织比值(1.298±0.054)(P<0.01)。结论:99Tcm-Citrate显像能无创地评估骨组织炎症的病理生理状态。99Tcm-Citrate显示的是骨组织炎症实际累及范围,而99Tcm(V)-DMSA和99Tcm-MDP显示的是炎症所致的骨组织代谢增高范围。

The Value Studies of 99 Tcm-Citrate imaging/99Tcm(V)-DMSA and Semiquantitative Analysis in the Acute Purulent Osteoarthritis

Objective To assess the clinical diagnostic values of ^99Tc^m--citrate scan and ^99Tc^m （V）-DMSA scan in the acute purulent osteoarthritis. Methods The seventeen patients referred for investigation of acute purulent osteoarthritis and the nineteen patients referred for investigation of no-purulent osteoarthritis were studied. In all patients, a bone scan of ^99Tc^m-MDP obtained initially. Subsequently, comparative with ^99Tc^m-citrate scan and ^99Tc^m（V）-DMSA scan, at the same time, to make a semiquantitative analysis. Results In the acute purulent osteoarthritis group, there are positive trend-bone accumulations at certain areas of three kinds of imaging. In the no-purulent osteoarthritis group,^99Tc^m-MDP scan and^99Tc^m（V） -DMSA scan had clearly trend-bone accumulation, but ^99Tc^m-citrate scan had only light trend-bone accumulation, or not besides the soft tissue accumulations at certain areas. Lesion to nonlesion ratios （L/N=2.300± 0.094） of acute purulent osteoarthritis are greater than that of no-purulent osteoarthritis group （1.298± 0.054）（P〈0.01） in ^99Tc^m-citrate scan, and there are not clearly different between two groups in ^99Tc^m （V）-DMSA scan （L/N ratios of acute purulent osteoarthritis group is 3.495± 0.180, and L/N ratios of no-purulent osteoarthritis group is 3.091 ±0.091. P〉0.05）. Conclusion To diagnose the bone inflammation, ^99Tc^m -citrate scan coalesced with ^99Tc^m-MDP scan or ^99Tc^m （V）-DMSA scan help to evaluate the patho- logic and physiologic progresses in bone inflammatory areas, at the same time, the information by ^99Tc^m-citrate scan is actual inflamnaation areas, and that by ^99Tc^m（V）-DMSA scan and ^99Tc^m-MDP scan is response to increase of bone metabolism.