99Tcm-Citrate和其半定量分析对急性化脓性骨关节炎诊断价值的研究.docVIP

99Tcm-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 　　作者：关则雄 作者单位：阳江市人民医院，广东 阳江 529500 　　【摘要】 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)(P0.01)。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。 　　【关键词】 化脓性骨关节炎 99m锝-枸橼酸 99m锝-二巯基丁二酸钠 　　The Value Studies of 99Tcm-Citrate imaging/99 Tcm(V)-DMSA and Semiquantitative Analysis in the Acute Purulent Osteoarthritis 　　GUAN Ze-xiong 　　(The Peoples Hospital of Yangjiang,Guangdong 529500,China) 　　Abstract: Objective To assess the clinical diagnostic values of 99Tcm-citrate scan and 99Tcm(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 99Tcm-MDP obtained initially. Subsequently, comparative with 99Tcm-citrate scan and99Tcm(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,99Tcm-MDP scan and99Tcm(V)-DMSA scan had clearly trend-bone accumulation, but 99Tcm-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)(P0.01) in99Tcm-citrate scan, and there are not clearly different between two groups in 99Tcm(V)-DMSA scan(L/N ratios of acute purulent osteoarthritis group is 3.495±0.180, and L/N ratios of no-pu