骨显像诊断股骨头缺血性坏死

目的　了解三相骨显像对于股骨头缺血性坏死的诊断价值。方法　出院诊断为股骨头缺血性坏死患者 31例 (36个坏死股骨头 ) ,多次门诊后确诊为股骨头缺血性坏死患者 17例 (2 0个坏死股骨头 ) ,共计 4 8例 5 6个缺血性坏死股骨头 ,对其进行99　TCm MDP三相骨显像。其中 31例 36个坏死股骨头有近期X线片检查结果 ,列表与骨显像结果作了对照。结果　 5 6个缺血性坏死股骨头静态骨显像均有相关坏死征象 ,血流相 37个有改变 (6 6 1% ) ,血池相 4 0个有改变 (71 4 % )。 36个坏死股骨头X线片结果为正常者 10个 (2 7 8% ) ,早期坏死 7个 (19 4 % ) ,坏死 19个 (5 2 8% ) ,诊断灵敏性低于骨显像。结论　三相骨显像对诊断股骨头缺血性坏死是一个准确、灵敏而简便的方法 ,可作为常规应用

Diagnosis of Ischemic Necrosis of the Head of Femur with Bone Schintigraphic Imaging

Objective To investigate the value of three-phase bone schintigraphic imaging in diagnosing the ischemic necrosis of the heads of femurs.Methods There were confirmed 36 necrotic heads of femurs in 31 cases,20 in 17 out-patient cases.Three-phase bone schintigraphic imaging with 99 T C m MDP was performed in all above 48 cases.Radiography was practiced in 36 necrotic heads of femurs of above 48 cases in the same period as bone schintigraphic imaging.The results of above two ways were compared in table.Results There were relevant necrotic marks in all 56 ischemic necrotic heads of femurs in static phase,in 37 in blood flow phase, and in 40 in blood pool phase.The radiographic results in 36 necrotic heads of femurs suggested 10 normal heads of femurs (27.8%),7 early necrotic ones (19.4%),19 necrotic ones (62.8%),which showed the sensitivity of radiography in diagnosing necrotic heads of femurs was lower than bone schintigraphic imaging.Conclusion Three-phase bone schintigraphic imaging is an accurate,sensitive and simple way to diagnosis of the ischemic necrosis of head of femur.