[1]刘艳,谢新立,杜彪,等.SPECT全身骨显像在儿童和青少年腰痛诊断中的价值[J].中医正骨,2017,29(04):42-45.
点击复制

SPECT全身骨显像在儿童和青少年腰痛诊断中的价值()
分享到:

《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第29卷
期数:
2017年04期
页码:
42-45
栏目:
影像诊断
出版日期:
2017-04-20

文章信息/Info

作者:
刘艳谢新立杜彪阮翘韩星敏
郑州大学第一附属医院,河南 郑州 450052
关键词:
腰痛 体层摄影术发射型计算机单光子 全身骨显像 儿童 青少年
摘要:
目的:探讨SPECT全身骨显像在儿童和青少年腰痛诊断中的价值。方法:收集2012年5月至2014年10月因腰痛在郑州大学第一附属医院就诊的93例患儿的病例资料。男56例,女37例; 年龄4~15岁,中位数9岁; 病程8~38 d,中位数15 d。所有患儿最初的实验室检查和常规X线检查结果均为阴性或不能确诊。均采用Discovery NM/CT670型单光子发射断层扫描仪行SPECT全身骨显像检查,显像剂选用99mTc-MDP。由2位有5年以上诊断经验的核医学医师共同阅片确定是否存在阳性病变,最终通过病理检查联合MRI或CT检查予以确诊。结果:22例SPECT全身骨显像诊断为阳性,均经病理检查联合MRI或CT检查确诊; 71例SPECT全身骨显像诊断为阴性的患儿仅2例确诊为假阴性,经MRI诊断为腰椎间盘突出症。诊断的灵敏度为91.7%(22/24)、特异度为100%(69/69)、准确度为97.8%(91/93),阳性预测值和阴性预测值分别为100%(22/22)和97.2%(69/71)。22例SPECT全身骨显像检查阳性的病例中,病灶位于脊柱11例、骨盆3例、骶髂关节3例、髋关节3例、骨外组织2例; 恶性肿瘤骨转移7例、骨髓炎5例、骶髂关节炎3例、腰椎峡部裂3例、良性骨肿瘤2例和非骨性病变2例。结论:SPECT全身骨显像能准确探测多种引起儿童和青少年腰痛的骨骼病变和非骨性病变,其灵敏度和特异度均较高。建议将此检查作为儿童和青少年腰痛的首次影像检查方法,以避免不必要的检查或延误诊断。

参考文献/References:

[1] MASSOUD M,DEL BUFALO F,CATERINA MUSOLINO AM,et al.Myeloid sarcoma presenting as low back pain in the pediatric emergency department[J].J Emerg Med,2016,51(3):308-314.
[2] TREVAIL C,RAVINDRANATH-REDDY P,SULKIN T,et al.An evaluation of the role of nuclear medicine imaging in the diagnosis of periprosthetic infections of the hip[J].Clin Radiol,2016,71(3):211-219.
[3] IZZO R,POPOLIZIO T,D'APRILE P,et al.Spinal pain[J].Eur J Radiol,2015,84(5):746-756.
[4] 董薇,李眉,戴皓洁,等.SPECT和CT融合骨显像在小儿神经母细胞瘤中的应用[J].中华核医学与分子影像杂志,2011,31(6):386-389.
[5] EVEN-SAPIR E.Imaging of malignant bone involvement by morphologic,scintigraphic,and hybrid modalities[J].J Nucl Med,2005,46(8):1356-1367.
[6] MURPHEY MD,SENCHAK LT,MAMBALAM PK,et al.From the radiologic pathology archives ewing sarcoma family of tumors:Radiologic-Pathologic correlation[J].Radiographics,2013,33(3):803-831.
[7] IYER RS,CHAPMAN T,CHEW FS.Pediatric bone imaging:diagnostic imaging of osteoid osteoma[J].AJR Am J Roentgenol,2012,198(5):1039-1052.
[8] ROY SL,SHAW PC,BEATTIE TF.Low back pain in the paediatric athlete[J].Eur J Emerg Med,2015,22(5):348-354.
[9] CONNOLLY LP,D'HEMECOURT PA,CONNOLLY SA,et al.Skeletal scintigraphy of young patients with low-back pain and a lumbosacral transitional vertebra[J].J Nucl Med,2003,44(6):909-914.

相似文献/References:

[1]鲁建作,林央央,杨杰,等.皮质骨螺钉内固定治疗下胫腓联合分离的CT研究[J].中医正骨,2015,27(11):13.
 LU Jianzuo,LIN Yangyang,YANG Jie,et al.Internal fixation with cortical bone screws for the treatment of distal tibiofibular syndesmosis separation:a CT study of 32 patients[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(04):13.
[2]宁兴明,伍亮,王廷,等.五禽戏配合核心肌力训练治疗非特异性腰痛的临床研究[J].中医正骨,2015,27(11):25.
 NING Xingming,WU Liang,WANG Ting,et al.Clinical study on five mimic-animal boxing combined with core muscular strength exercise for the treatment of nonspecific low back pain[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(04):25.
[3]谢凯罗,董伊隆,张力成.前交叉韧带单束解剖重建术股骨隧道定位的X线评估[J].中医正骨,2015,27(10):11.
 XIE Kailuo,DONG Yilong,ZHANG Licheng.Roentgenologic evaluation of femoral tunnel positioning in anterior cruciate ligament single-bundle anatomical reconstruction[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(04):11.
[4]宋兵华,孙俊英,倪增良,等.全膝关节置换术前CT测量股骨后髁角的临床意义[J].中医正骨,2015,27(07):38.
[5]陈利军,田野,刘文刚,等.非典型膝关节外伤后胫骨近端隐匿性骨折的影像诊断[J].中医正骨,2015,27(06):26.
[6]金立昆,齐越峰,唐可,等.中药离子导入联合腰背部功能锻炼治疗 非特异性腰痛的临床研究[J].中医正骨,2016,28(01):20.
 JIN Likun,QI Yuefeng,TANG Ke,et al.Clinical study on iontophoresis of traditional Chinese medicine combined with lower back functional exercise for treatment of non-specific low back pain[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2016,28(04):20.
[7]陈颖瑜,潘爱珍,黄慧玲.弥漫性特发性骨肥厚症的影像诊断[J].中医正骨,2016,28(01):31.
[8]谢凤利,霍群普,张子静,等.骨膜增生厚皮症的影像诊断[J].中医正骨,2016,28(02):41.
[9]杨勇,王雷生,张娟.经椎关节突关节温针治疗腰椎关节突关节源性腰痛[J].中医正骨,2016,28(02):67.
[10]郭会利,叶艳君,李盼盼,等.云克静脉滴注联合活血通络方口服治疗 距骨骨软骨损伤的临床研究[J].中医正骨,2016,28(03):9.
 GUO Huili,YE Yanjun,LI Panpan,et al.Clinical study on intravenous drip of Yunke(云克)combined with oral application of Huoxue Tongluo Fang(活血通络方)for treatment of talar osteochondral injury[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2016,28(04):9.

备注/Memo

备注/Memo:
通讯作者:韩星敏 E-mail:xmhan@qq.com
更新日期/Last Update: 1900-01-01