Japanese
Title人工股関節置換術施行例におけるIn-111標識白血球シンチグラフィと骨シンチグラフィの臨床検討
Subtitle原著
Authors寺内隆司*, 宇野公一*, 湯山琢夫*, 瀬戸一彦*, 有水昇*, 勝呂徹**, 守屋秀繁**, 植松貞夫***
Authors(kana)
Organization*千葉大学医学部放射線科, **整形外科, ***附属病院中央放射線部
Journal核医学
Volume25
Number10
Page1103-1109
Year/Month1988/10
Article原著
Publisher日本核医学会
Abstract「要旨」人工股関節置換術後における人工関節周囲の感染の有無をTc-99m MDPシンチゲラフィ(以下骨シンチ)とIn-111標識白血球シンチグラフィ(以下白血球シンチ)で評価した. 白血球シンチは, 骨髄, 肝, 脾の網内系に正常集積を示すが, 人工関節置換術では骨髄を抜去したうえで人工関節を装着するので, 人工関節部においては骨髄は描出されず, 異常のない人工関節においては集積は認められない. したがって, 人工関節部に集積を認めた場合これを異常すなわち感染ありと診断できる. 今回, われわれの研究では, 人工股関節全置換術を施行した13症例中, 感染症例は4例であり, そのうち3例3検査に対して骨シンチでびまん性集積を認め, 4例4検査に対して白血球シンチで陽性像を認め, 両検査とも良好な結果を得, とりわけ白血球シンチの人工関節周囲における感染に対する診断能が優ることが示唆された.
Practice臨床医学：一般
KeywordsTotal hip replacement, In-111 labeled leukocyte, Tc-99m MDP, Loosening, Prosthetic infection.
English
TitleClinical Usage of Indium-111 Labeled Leukocyte Scintigraphy and Technetium-99m Methylene Diphosphonate Scintigraphy in Patients with Total Hip Replacement
Subtitle
AuthorsTakashi TERAUCHI*, Kimiichi UNO*, Takuo YUYAMA*, Kazuhiko SETO*, Noboru ARIMIZU*, Tohru SUGURO**, Hideshige MORIYA**, Sadao UEMATSU***
Authors(kana)
Organization*Department of Radiology, School of Medicine, Chiba University, **Department of Orthopedics, School of Medicine, Chiba University, ***Central Division of Radiology, Chiba University Hospital
JournalThe Japanese Journal of nuclear medicine
Volume25
Number10
Page1103-1109
Year/Month1988/10
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
AbstractTc-99m methylene diphosphonate (MDP) scintigraphy and In-111 labeled leukocyte scintigraphy were done in 13 patients with total hip replacement in order to determine the presence of prosthetic infection. Tc-99m MDP scintigraphy was done in 11 patients (12 studies). In-111 labeled leukocyte scintigraphy was done in 13 patients (14 studies). Tc-99m MDP imaging showed diffuse accumulation of the radionuclide in all of the 3 infected lesions, but focal one in 5 of the 7 noninfected lesions with a specificity of 33.3%, sensitvity of 100%, overall accuracy of 50%. In-111 labeled leukocyte normally accumulates in the spleen, the liver, and the bone marrow. Before insertion of a stemmed prosthesis, the local bone marrows were reamed out in all of our cases. Thus, no radioactive accumulation would be expected in the lesions with prosthesis unless infected. However, if the prosthesis is infected, increased uptake of In-111 would be seen as a result of the accumulation of leukocyte. In-111 labeled leukocyte imaging showed abnormal accumulation of In-111 in all of the 4 infected lesions and no accumulation in all of the 10 noninfected lesions with a specificity of 100%, sensitivity of 100%, overall accuracy of 100%. We conclude that In-111 labeled leukocyte scintigraphy might be useful in evaluating prosthetic infection in a patient with total hip replacement.
PracticeClinical medicine
KeywordsTotal hip replacement, In-111 labeled leukocyte, Tc-99m MDP, Loosening, Prosthetic infection.

【全文PDF】