SPECT/CT融合骨显像评价四肢骨折远期愈合

目的 探讨SPECT/CT融合骨显像技术评价四肢骨折远期愈合情况的价值。方法 回顾性分析68例四肢骨折患者经治疗6个月后骨折端SPECT/CT融合骨显像特征，判断骨折愈合情况，并与临床随诊或手术情况对照，计算SPECT/CT判断骨折能否远期愈合的准确率。结果 68例四肢骨折，X线或CT检查均不能明确判断骨折能否远期愈合。SPECT/CT融合骨显像中，52例患者见连续性放射浓聚通过骨折线并跨越两侧骨折端，提示骨折处于愈合进程中，具有远期愈合可能；经临床随诊证实46例骨折愈合，6例未愈合。16例骨折端未见明显连续性通过骨折线的放射性浓聚，提示骨折不愈合，且远期愈合的可能性较小；均经手术治疗并证实为骨折不愈合。SPECT/CT融合骨显像判断骨折愈合的准确率为91.18%（62/68）。结论 SPECT/CT融合骨显像可准确评价四肢骨折远期愈合情况，对指导临床制定骨折治疗方案具有重要价值。

SPECT/CT fusion of bone scintigraphy in evaluation on long-term healing of limb fractures

Objective To explore the value of SPECT/CT in evaluation on long-term healing of limb fractures. Methods SPECT/CT imaging characteristics of 68 patients with limb fractures 6 months after treatment were analyzed retrospectively, and the self-healing property of fractures was evaluated. Compared with clinical follow-up results or surgical findings, the accuracy of SPECT/CT in evaluation on long-term healing of fractures was calculated. Results For all 68 patients with limb fractures, X-ray and CT were not able to determine whether the fractures would heal in the future. On SPECT/CT fusion images, radioactivity concentrations through the fracture lines and cross on both sides of fracture were found in 52 patients, which indicated that the fractures were in the process of healing and had the ability of healing in the future. Clinical follow-up confirmed that fractures then healed in 46 patients, while in 6 patients did not. Another 16 patients showed no nuclide concentrations on the fractures, indicated that the fractures were nonunion and had little ability of healing in the future, and were finally confirmed with surgery. The accuracy of SPECT/CT in evaluation on fracture healing was 91.18% (62/68). Conclusion SPECT/CT imaging can accurately evaluate the long-term healing of limb fractures, which contributes to therapeutic planning in the clinic.