Japanese
Title非外傷性大腿骨頭壊死症における骨シンチグラフィ所見とSPECT検査付加の診断的価値
Subtitle原著
Authors蓑島聡*,**, 内田佳孝*, 安西好美*, 宇野公一*, 有水昇*
Authors(kana)
Organization*千葉大学医学部放射線科, **(現職)Division of Nuclear Medicine, Department of Internal Medicine, The University of Michigan
Journal核医学
Volume31
Number9
Page1085-1092
Year/Month1994/9
Article原著
Publisher日本核医学会
Abstract「要旨」非外傷性大腿骨頭壊死症における骨シンチグラフィ所見を分類し, SPECT検査付加の診断的価値について26症例43骨頭を対象に検討を行った. Planar, SPECT像所見は6種類に分類した:正常(N), 欠損(C), 集積増加を伴う欠損(PH+C), リング状集積(RH+C), 部分的な集積増強(PH), び漫性集積増加(DH). 壊死を伴う24骨頭におけるplanar, SPECT像所見は, それぞれNが3:2(骨頭), Cが1:3, PH+Cが2:8, RH+Cが2:3, PHが9:2, DHが7:6であった. 壊死のない19骨頭においては, Nが16:12, Cが0:6, DHが3:1であった. 欠損を伴う所見を骨頭壊死の確定的診断所見とした場合, planar, SPECT像の感度は, それぞれ21%:58%, 特異性は100%:68%であった. Planar像が正常を呈した19骨頭のうち, SPECTは2骨頭で壊死を断定し, 6骨頭で正常骨頭を誤って壊死と断定した. 骨頭壊死と断定できない異常(PH, DH)を呈した19骨頭では, SPECTは7骨頭で壊死を断定し, 偽陽性はなかった. 以上の結果は, 視覚的な所見分類で骨頭壊死と断定できない異常所見を呈した場合に, SPECT検査が有用となることを示唆した.
Practice臨床医学：一般
KeywordsBone scintigraphy, Avascular necrosis, Femoral head, Single-photon emission computed tomography.
English
TitleNontraumatic Femoral Head Necrosis : Classification of Bone Scintigraphic Findings and Diagnostic Value of SPECT Following Planar Imaging
Subtitle
AuthorsSatoshi MINOSHIMA, Yoshitaka UCHIDA, Yoshimi ANZAI, Kimiichi UNO, Noboru ARIMIZU
Authors(kana)
OrganizationDepartment of Radiology, Chiba University School of Medicine
JournalThe Japanese Journal of nuclear medicine
Volume31
Number9
Page1085-1092
Year/Month1994/9
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
Abstract[Summary] This study was conducted to determine bone scintigraphic findings in nontraumatic femoral head avascular necrosis and diagnostic value of SPECT imaging following a conventional planar imaging. Forty-three femoral heads in twenty-six cases with idiopathic femoral head necrosis (n=2), systemic lupus erythematosus (n=22), aplastic anemia (n=1), and renal transplantation (n=1) were studied. The diagnosis for femoral head necrosis was based on magnetic resonance imaging as well as other diagnostic studies in all cases. Scintigraphic findings of planar and SPECT images were classified into six categories: normal (N); cold or decrease (C); partial increase with cold or decrease (PH+C); ring-like increase with a cold center (RH+C); partial increase (PH); diffuse and/or irregular increase (DH). Avascular necrosis was confirmed in twenty-four femoral heads, in which planar and SPECT images showed scintigraphic findings of N (n=3, 2), C (n=1, 3), PH+C (n=2, 8), RH+C (n=2, 3), PH (n=9, 2), and DH (n=7, 6), respectively. Femoral heads without avascular necrosis demonstrated planar and SPECT findings of N (n=16, 12), C (n=0,6), and DH (n=3,1), respectively. When considering C, PH+C, and RH+C as diagnostic findings for avascular necrosis, sensitivities of planar and SPECT images were 21% and 58%, and specificities were 100% and 68%, respectively. In nineteen femoral heads with normal planar findings (N), SPECT correctly identified avascular necrosis in two femoral heads and misidentified six normal femoral heads as avascular necrosis. In nineteen femoral heads with non-diagnostic abnormalities (PH, DH), SPECT correctly identified avascular necrosis in seven femoral heads and showed no false positive. Diagnostic planar findings in five femoral heads were concordant with SPECT diagnosis. These results indicate that SPECT imaging is most valuable when planar images show nondiagnostic abnormalities based on the proposed classification of scintigraphic findings.
PracticeClinical medicine
KeywordsBone scintigraphy, Avascular necrosis, Femoral head, Single-photon emission computed tomography.

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