SPECT/CT对全髋关节置换术后无菌性假体松动的诊断价值

目的探讨SPECT/CT对全髋关节置换术后无菌性假体松动的诊断价值。方法对临床疑似全髋关节置换术后假体松动的58例患者(69个髋关节),行SPECT/CT检查,观察分析其图像特征。最终结果由手术或5个月以上随访确诊。计算SPECT/CT显像对假体松动的诊断灵敏度、特异度和准确度。结果69个髋关节,临床最终确诊假体松动61个(髋臼松动17个,假体柄松动36个,髋臼及假体柄均松动8个)。SPECT/CT显像阳性64个(其中假阳性3个,余61个与手术结果一致);阴性5个,均为真阴性。SPECT/CT对假体松动的诊断灵敏度、特异度、准确度分别为100%(61/61)、62.50%(5/8)、95.65%(66/69)。结论SPECT/CT显像可灵敏、准确地诊断全髋关节置换术后无菌性假体松动的情况,值得临床推广。

The diagnostic value of SPECT/CT in aseptic prosthesis looseness after total hip replacement

Objective To evaluate the diagnostic value of SPECT/CT in aseptic prosthesis looseness after total hip replacement.Methods SPECT/CT was performed in 58 patients(69 hips)who clinically suspected of prosthesis looseness after total hip replacement.We observed and analyzed the image features.Final results were confirmed by surgery or followed up more than 5 months.The diagnostic sensitivity,specificity and accuracy of SPECT/CT for prosthesis looseness were calculated.Results Of the 69 hip joints,61 were finally diagnosed as prosthesis looseness clinically(17 acetabular looseness,36 prosthesis handle looseness,8 acetabular and prosthesis handle looseness).There were 64 positive SPECT/CT images(3 false positive and 61 consistent with the surgical results).5 were negative,all of whom were true negative.The diagnostic sensitivity,specificity and accuracy of SPECT/CT were 100%(61/61),62.50%(5/8)and 95.65%(66/69),respectively.Conclusion SPECT/CT can sensitively and accurately diagnose aseptic prosthesis looseness after total hip arthroplasty.It is worthy of clinical promotion.