摘要
目的:探讨SPECT/CT对全髋关节假体置换术后疼痛原因的诊断价值。方法 :对2009年10月—2016年12月230个(185例患者)假体置换术后疼痛而DR及CT未能明确诊断的髋关节,行99mTc-MDP SPECT/CT显像探查原因。疼痛原因最终诊断经手术或临床随访及影像学证实,所有病例随访时间大于6月。计算SPECT/CT显像的诊断效能。结果:SPECT/CT显像阳性156个,均为真阳性,其中髋关节假体无菌性松动123个(假体柄松动71个、髋臼假体松动34个、髋臼及假体柄均松动18个),感染性松动25个,股骨骨折8个。SPECT/CT显像阴性74个(其中5个假阴性,余69个随访证实均为非假体及骨质源性疼痛)。SPECT/CT对全髋关节置换术后假体或骨源性疼痛原因诊断符合率为96.89%(156/161)。结论:在DR及CT检查未能明确诊断髋关节假体置换术后疼痛原因时,SPECT/CT显像可为临床提供有价值的参考信息。
Objective： To evaluate the diagnostic value of SPECT/CT at pain cause after hip prosthesis replacement.Methods： From Oct. 2009 to Dec. 2016, 230 hips prosthesis replacement（185 patients） with unknown pain were included in this study. CT and DR failed to find the cause of pain, then SPECT/CT imaging were carried out. The final diagnoses were made according to surgery, imaging results, or treatment outcome. All patients were followed up at least 6 months. Diagnostic efficiency of SPECT/CT was calculated. Results： One huandred and fifty-six hip joints had positive findings by SPECT/CT imaging, including 123 hip joints aseptic loosening（71 hip joints prosthesis handle loosening, 34 hip joints acetabular component loosening, 18 hip joints both loosening）, 25 hip joints infection, 8 hip joints femoral stress fracture. SPECT/CT shows negative 74 hip joints（5 hip joints false negative, 69 hip joints non prosthesis or bone-derived pain）. For pain cause due to prosthesis or bone-derived after hip prosthesis replacement, the diagnosis of the coincidence rate was 96.89%（156/161） by SPECT/CT. Conclusion： Once DR and CT imaging failed to diagnose the cause of pain after hip prosthesis replacement,SPECT/CT imaging may provide valuable reference information for clinical.
作者
张斌青
宋青凤
郭会利
ZHANG Bin-qing;SONG Qing-feng;GUO Hui-li(Medical Imaging Center,Luoyang Orthopedic Hospital of Henan Province,Orthopedic Hospital of Henan Province,Luoyang Henan 471002,China)
出处
《中国临床医学影像杂志》
CAS
2018年第8期584-586,共3页
Journal of China Clinic Medical Imaging
