中华核医学与分子影像杂志
中華覈醫學與分子影像雜誌
중화핵의학여분자영상잡지
Chinese Journal of Nuclear Medicine and Molecular Imaging
2012年
6期
438-441
,共4页
颞下颌关节疾病%下颌骨髁状突%放射性核素显像%MDP
顳下頜關節疾病%下頜骨髁狀突%放射性覈素顯像%MDP
섭하합관절질병%하합골과상돌%방사성핵소현상%MDP
Temporomandibular joint diseases%Mandibular condyle%Radionuclide imaging%MDP
目的 探讨99Tcm-MDP SPECT颞颌关节显像对髁突肥大的诊断价值.方法 回顾性分析2009年至2010年行99Tcm-MDP SPECT颞颌关节显像的髁突肥大(临床确诊)患者56例(男22例,女34例,平均年龄21.5岁),其中31例接受了髁突高位切除术并有组织病理学结果.另收集10例因恶性肿瘤等其他疾病行骨显像的对照者,男女各5例,平均年龄22.6岁,加做颞颌关节显像.对所有研究对象进行SPECT图像分析及半定量分析,采用独立样本t检验比较髁突肥大组与对照组间患侧髁突/顶骨及患侧髁突/双侧髁突的摄取比差异,髁突肥大组患侧与健侧的摄取差异行配对t检验.对手术治疗患者的SPECT结果与其病理结果进行Pearson相关分析.结果 髁突肥大组患侧髁突/顶骨摄取比(1.66 ±0.63)及患侧髁突/双侧髁突摄取比(0.59±0.44)均明显高于对侧(1.34±0.34、0.41±0.04,t=3.687和6.590,均P＜0.01),并且明显高于对照组左侧髁突相应数据(1.12 ±0.07和0.50±0.01,t =6.459和4.750,均P＜0.001).SPECT检查诊断髁突生长活跃的灵敏度为95.2％(20/21),特异性为60.0％(6/10),阳性预测值为83.3％ (20/24),阴性预测值为6/7.患侧髁突/双侧髁突摄取比与软骨组织增生的厚度无明显相关[软骨膜、增殖层、肥大层的平均厚度分别为(150.5±94.9)、(185.2±113.6)、(167.7 ±76.9)μm,r=0.46、0.47、-0.12,均P＞0.05].结论 99Tcm-MDP SPECT颞颌关节显像能够有效评估髁突肥大患者的骨质生长活性,为手术方式的选择提供重要依据.
目的 探討99Tcm-MDP SPECT顳頜關節顯像對髁突肥大的診斷價值.方法 迴顧性分析2009年至2010年行99Tcm-MDP SPECT顳頜關節顯像的髁突肥大(臨床確診)患者56例(男22例,女34例,平均年齡21.5歲),其中31例接受瞭髁突高位切除術併有組織病理學結果.另收集10例因噁性腫瘤等其他疾病行骨顯像的對照者,男女各5例,平均年齡22.6歲,加做顳頜關節顯像.對所有研究對象進行SPECT圖像分析及半定量分析,採用獨立樣本t檢驗比較髁突肥大組與對照組間患側髁突/頂骨及患側髁突/雙側髁突的攝取比差異,髁突肥大組患側與健側的攝取差異行配對t檢驗.對手術治療患者的SPECT結果與其病理結果進行Pearson相關分析.結果 髁突肥大組患側髁突/頂骨攝取比(1.66 ±0.63)及患側髁突/雙側髁突攝取比(0.59±0.44)均明顯高于對側(1.34±0.34、0.41±0.04,t=3.687和6.590,均P＜0.01),併且明顯高于對照組左側髁突相應數據(1.12 ±0.07和0.50±0.01,t =6.459和4.750,均P＜0.001).SPECT檢查診斷髁突生長活躍的靈敏度為95.2％(20/21),特異性為60.0％(6/10),暘性預測值為83.3％ (20/24),陰性預測值為6/7.患側髁突/雙側髁突攝取比與軟骨組織增生的厚度無明顯相關[軟骨膜、增殖層、肥大層的平均厚度分彆為(150.5±94.9)、(185.2±113.6)、(167.7 ±76.9)μm,r=0.46、0.47、-0.12,均P＞0.05].結論 99Tcm-MDP SPECT顳頜關節顯像能夠有效評估髁突肥大患者的骨質生長活性,為手術方式的選擇提供重要依據.
목적 탐토99Tcm-MDP SPECT섭합관절현상대과돌비대적진단개치.방법 회고성분석2009년지2010년행99Tcm-MDP SPECT섭합관절현상적과돌비대(림상학진)환자56례(남22례,녀34례,평균년령21.5세),기중31례접수료과돌고위절제술병유조직병이학결과.령수집10례인악성종류등기타질병행골현상적대조자,남녀각5례,평균년령22.6세,가주섭합관절현상.대소유연구대상진행SPECT도상분석급반정량분석,채용독립양본t검험비교과돌비대조여대조조간환측과돌/정골급환측과돌/쌍측과돌적섭취비차이,과돌비대조환측여건측적섭취차이행배대t검험.대수술치료환자적SPECT결과여기병리결과진행Pearson상관분석.결과 과돌비대조환측과돌/정골섭취비(1.66 ±0.63)급환측과돌/쌍측과돌섭취비(0.59±0.44)균명현고우대측(1.34±0.34、0.41±0.04,t=3.687화6.590,균P＜0.01),병차명현고우대조조좌측과돌상응수거(1.12 ±0.07화0.50±0.01,t =6.459화4.750,균P＜0.001).SPECT검사진단과돌생장활약적령민도위95.2％(20/21),특이성위60.0％(6/10),양성예측치위83.3％ (20/24),음성예측치위6/7.환측과돌/쌍측과돌섭취비여연골조직증생적후도무명현상관[연골막、증식층、비대층적평균후도분별위(150.5±94.9)、(185.2±113.6)、(167.7 ±76.9)μm,r=0.46、0.47、-0.12,균P＞0.05].결론 99Tcm-MDP SPECT섭합관절현상능구유효평고과돌비대환자적골질생장활성,위수술방식적선택제공중요의거.
Objective To investigate the clinical value of 99Tcm-MDP SPECT bone scintigraphy in diagnosis of unilateral condylar hyperplasia (UCH) of the mandible.Methods Temporomandibular joint tomography using 99Tcm-MDP SPECT was performed in 56 UCH patients (22 males,34 females,mean age 21.5 y) preoperatively and 10 controls with other diseases (5 males,5 females,mean age 22.6 y).Thirtyone UCH patients received high condylar resection,and the corresponding histopathological results were analyzed.All bone scintigrams were visually interpreted and supported by semi-quantitative assessment of bone activity in bilateral condyles using the skull as the reference site.The results of UCH patient and control groups were compared using two-sample and paired t tests.Pearson correlation analysis was also used.Results " Affected condyle/parietal bone" and "affected condyle/bilateral condyles" activity ratios (1.66 ±0.63 and 0.59 ±0.44) were significantly higher than those of the contralateral side (1.34 ±0.34 and 0.41 ±0.04 ; t =3.687 and 6.590,respectively,both P ＜ 0.01) and controls (1.12 ± 0.07 and 0.50 ± 0.01,t =6.459 and 4.750,respectively,both P ＜ 0.001).The sensitivity,specificity,positive and negative predictive values for the diagnosis of condylar hyperplasia were 95.2％ (20/21),60.0％ (6/10),83.3％ (20/24),and 6/7.The uptake on scintigraphy was not significantly related to the thickness of the cartilage (respective mean thicknesses of fibrous,proliferative,hypertrophic cartilage layers:(150.5 ± 94.9),(185.2 ±113.6),(167.7±76.9) μm,r=0.46,0.47,-0.12,all P＞0.05).Conclusion 99Tcm-MDPSPECT bone scintigraphy may be useful for assessment of growth activity of the mandibular condyle and to provide important information for condylar hyperplasia in surgical planning.
