中华核医学杂志
中華覈醫學雜誌
중화핵의학잡지
CHINESE JOURNAL OF NUCLEAR MEDICINE
2010年
4期
242-245
,共4页
李放%刘兴党%陆志辉%刘从进
李放%劉興黨%陸誌輝%劉從進
리방%류흥당%륙지휘%류종진
脑血管意外%偏瘫%复杂性区域性疼痛综合征%放射性核素显像%骨骼%MDP
腦血管意外%偏癱%複雜性區域性疼痛綜閤徵%放射性覈素顯像%骨骼%MDP
뇌혈관의외%편탄%복잡성구역성동통종합정%방사성핵소현상%골격%MDP
Cerebrovascular disorders%Hemiplegia%Complex regional pain syndromes%Radionuclide imaging%Skeleton%MDP
目的 探索三相骨扫描早期相和延迟相在判断卒中偏瘫早期复杂性区域性疼痛综合征患者的半定量研究结果方面是否存在差异.方法 29例入选的脑卒中偏瘫早期复杂性区域性疼痛综合征患者经静脉注射99Tcm-亚甲基二膦酸盐(MDP)后行三相骨扫描,半定量计数健侧和患侧的腕、掌指、指间和远指关节感兴趣区(ROI),比较健患侧差异(秩和检验).同时,计算各扫描相放射性计数总的患/健侧放射性比值,比较其差异(单因素方差分析和Bonferroni检验).结果 在灌注相、血池相和延迟相,患侧腕、掌指、近指、远指关节的ROI放射性计数均大于健侧(秩和检验,Z=-4.73～-2.10,P均＜0.05).各相的患/健侧放射性比值之间差异无统计学意义(单因素方差分析,F=0.807,P＞0.05).各相之间两两比较差异也无统计学意义(Bonferroni检验,s(-x)值均为0.29,(-x)=-0.31,-0.33,-0.03,P均＞0.05).结论 卒中偏瘫早期复杂性区域性疼痛综合征患者三相骨扫描均存在偏瘫侧腕及手部各关节的放射性浓聚,早期相和延迟相没有明显不同,三相均可用于该病的辅助诊断.
目的 探索三相骨掃描早期相和延遲相在判斷卒中偏癱早期複雜性區域性疼痛綜閤徵患者的半定量研究結果方麵是否存在差異.方法 29例入選的腦卒中偏癱早期複雜性區域性疼痛綜閤徵患者經靜脈註射99Tcm-亞甲基二膦痠鹽(MDP)後行三相骨掃描,半定量計數健側和患側的腕、掌指、指間和遠指關節感興趣區(ROI),比較健患側差異(秩和檢驗).同時,計算各掃描相放射性計數總的患/健側放射性比值,比較其差異(單因素方差分析和Bonferroni檢驗).結果 在灌註相、血池相和延遲相,患側腕、掌指、近指、遠指關節的ROI放射性計數均大于健側(秩和檢驗,Z=-4.73～-2.10,P均＜0.05).各相的患/健側放射性比值之間差異無統計學意義(單因素方差分析,F=0.807,P＞0.05).各相之間兩兩比較差異也無統計學意義(Bonferroni檢驗,s(-x)值均為0.29,(-x)=-0.31,-0.33,-0.03,P均＞0.05).結論 卒中偏癱早期複雜性區域性疼痛綜閤徵患者三相骨掃描均存在偏癱側腕及手部各關節的放射性濃聚,早期相和延遲相沒有明顯不同,三相均可用于該病的輔助診斷.
목적 탐색삼상골소묘조기상화연지상재판단졸중편탄조기복잡성구역성동통종합정환자적반정량연구결과방면시부존재차이.방법 29례입선적뇌졸중편탄조기복잡성구역성동통종합정환자경정맥주사99Tcm-아갑기이련산염(MDP)후행삼상골소묘,반정량계수건측화환측적완、장지、지간화원지관절감흥취구(ROI),비교건환측차이(질화검험).동시,계산각소묘상방사성계수총적환/건측방사성비치,비교기차이(단인소방차분석화Bonferroni검험).결과 재관주상、혈지상화연지상,환측완、장지、근지、원지관절적ROI방사성계수균대우건측(질화검험,Z=-4.73～-2.10,P균＜0.05).각상적환/건측방사성비치지간차이무통계학의의(단인소방차분석,F=0.807,P＞0.05).각상지간량량비교차이야무통계학의의(Bonferroni검험,s(-x)치균위0.29,(-x)=-0.31,-0.33,-0.03,P균＞0.05).결론 졸중편탄조기복잡성구역성동통종합정환자삼상골소묘균존재편탄측완급수부각관절적방사성농취,조기상화연지상몰유명현불동,삼상균가용우해병적보조진단.
Objective To investigate the difference between the early phases and delay phase of three-phase bone scintigraphy on hemiplegic patients with earlier complex regional pain syndrome (CRPS).Methods Twenty-nine stroke patients with hemiplegia complicating CRPS received three-phase bone scintigraphy after intravenous injection of 99Tcm-methylene diphosphonate (MDP). The region of interest (ROI)technique was used to obtain the radioactive counts of involved joints and contralateral sites on wrists,metacarpophalangeal,proximal interphalangeal and distal interphalangeal joints. The total counts of these four sites in each patient were then obtained and the total uptake ratios of involved joints/contralateral joints for each phase were calculated to compare the difference among the three phases. Wilcoxon test and ANOVA were used in data analyses. Results The involved joints of hemiplegic side displayed higher tracer uptake.There were significant differences of the radioactive counts between involved joints and uninvolved ones in the perfusion,pool and delay phase (Wilcoxon test,Z:-4.73 to -2.10,P＜0.05). There was no significant difference of total uptake ratios of involved joints/contralateral joints among the three phases ( ANOVA,F = 0. 807,P ＞ 0.05 ). Conclusions Due to higher bone seeking agent accumulation on three-phase bone scintigraphy,both early phases and delay phase imaging showed similar value in stroke patients with hemiplegia complicating earlier CRPS.
