{"title":"[99mTc]MDP SPECT/CT半定量分析在MRI禁忌症患者疑似新鲜骨质疏松性椎体压缩性骨折的责任病灶定位中的价值","authors":"Sheng Shi, Hai-Dong Cai, Gai-Xia Lu, Li-Guo Zhang, Shuang Zheng, Shi-Sheng He","doi":"10.1111/cpf.12923","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Purpose</h3>\n \n <p>The aim of this study was to evaluate the effectiveness of single-photon emission computed tomography/computed tomography (SPECT/CT) in detecting and localizing the causative vertebra in cases of suspected fresh osteoporotic vertebral compression fractures (OVCFs) in patients with contraindications to MRI.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>A total of 21 patients with severe back pain with 31 suspected OVCF segments and contraindications to MRI were initially identified through radiographs and the back pain-inducing test (BPIT). The responsible vertebral bodies were determined using [<sup>99m</sup>Tc]MDP SPECT/CT before percutaneous vertebroplasty (PVP). Clinical outcomes and radiographic parameters, including basic demographics, injury duration, focal kyphosis (FK), loss of vertebral height (LVH), and relative intensity values (RIVs) for target and nontarget segments in the SPECT/CT were measured.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>SPECT/CT identified 14 old and 26 fresh OVCFs. Of these, 18 patients with 26 fresh OVCF segments underwent PVP, and achieved satisfactory outcomes. Significant differences were observed in the RIV, FK, and LVH values between the fresh and old OCVF groups (all <i>p</i> < 0.05). RIVs showed a significant negative correlation with injury duration (r = −0.57, <i>p</i> < 0.05), and a positive correlation with LVH (r = 0.43, <i>p</i> < 0.05). Multiple linear regression analysis confirmed that injury duration was an independent predictor of RIVs (<i>p</i> < 0.05).</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>SPECT/CT is useful for detecting and differentiating fresh fractures from old fractures in patients having OVCF who cannot undergo MRI after BPIT validation, allowing these patients to achieve excellent clinical outcomes following PVP. The RIV serves as a valuable parameter for assessing the duration of fresh versus old OVCFs.</p>\n </section>\n \n <section>\n \n <h3> Trial Registration</h3>\n \n <p>ChiCTR, ChiCTR 2300077570. Retrospectively registered, http://www.chictr.org.cn/showproj.html?proj=206192.</p>\n </section>\n </div>","PeriodicalId":10504,"journal":{"name":"Clinical Physiology and Functional Imaging","volume":"45 1","pages":""},"PeriodicalIF":1.3000,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The value of semiquantitative analysis of [99mTc]MDP SPECT/CT in localizing responsible lesions for suspected fresh osteoporotic vertebral compression fractures in patients with contraindications to MRI\",\"authors\":\"Sheng Shi, Hai-Dong Cai, Gai-Xia Lu, Li-Guo Zhang, Shuang Zheng, Shi-Sheng He\",\"doi\":\"10.1111/cpf.12923\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Purpose</h3>\\n \\n <p>The aim of this study was to evaluate the effectiveness of single-photon emission computed tomography/computed tomography (SPECT/CT) in detecting and localizing the causative vertebra in cases of suspected fresh osteoporotic vertebral compression fractures (OVCFs) in patients with contraindications to MRI.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>A total of 21 patients with severe back pain with 31 suspected OVCF segments and contraindications to MRI were initially identified through radiographs and the back pain-inducing test (BPIT). The responsible vertebral bodies were determined using [<sup>99m</sup>Tc]MDP SPECT/CT before percutaneous vertebroplasty (PVP). Clinical outcomes and radiographic parameters, including basic demographics, injury duration, focal kyphosis (FK), loss of vertebral height (LVH), and relative intensity values (RIVs) for target and nontarget segments in the SPECT/CT were measured.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>SPECT/CT identified 14 old and 26 fresh OVCFs. Of these, 18 patients with 26 fresh OVCF segments underwent PVP, and achieved satisfactory outcomes. Significant differences were observed in the RIV, FK, and LVH values between the fresh and old OCVF groups (all <i>p</i> < 0.05). RIVs showed a significant negative correlation with injury duration (r = −0.57, <i>p</i> < 0.05), and a positive correlation with LVH (r = 0.43, <i>p</i> < 0.05). 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引用次数: 0
摘要
目的：本研究的目的是评估单光子发射计算机断层扫描/计算机断层扫描（SPECT/CT）在MRI禁忌症患者疑似新鲜骨质疏松性椎体压缩性骨折（OVCFs）病例中检测和定位病因椎体的有效性。方法：通过x线片和腰痛诱发试验（BPIT）初步确定21例重度腰痛患者，31个疑似OVCF节段，MRI禁忌症。经皮椎体成形术（PVP）前使用[99mTc]MDP SPECT/CT确定责任椎体。临床结果和影像学参数，包括基本人口统计学、损伤持续时间、局灶性后凸（FK）、椎体高度损失（LVH）以及靶节段和非靶节段在SPECT/CT上的相对强度值（RIVs）。结果：SPECT/CT检出14例旧OVCFs， 26例新OVCFs。其中，18例26个新鲜OVCF节段患者接受了PVP治疗，并取得了满意的结果。新旧OCVF组RIV、FK、LVH值差异均有统计学意义（p < 0.05）。RIVs与损伤持续时间呈显著负相关（r = -0.57, p < 0.05），与LVH呈正相关（r = 0.43, p < 0.05）。多元线性回归分析证实，损伤时间是RIVs的独立预测因子（p < 0.05）。结论：对于BPIT验证后无法接受MRI的OVCF患者，SPECT/CT可用于检测和区分新骨折和旧骨折，使这些患者在PVP后获得良好的临床结果。RIV是评估新鲜OVCFs与旧OVCFs持续时间的一个有价值的参数。试验注册：ChiCTR， ChiCTR 2300077570。追溯登记，http://www.chictr.org.cn/showproj.html?proj=206192。
The value of semiquantitative analysis of [99mTc]MDP SPECT/CT in localizing responsible lesions for suspected fresh osteoporotic vertebral compression fractures in patients with contraindications to MRI
Purpose
The aim of this study was to evaluate the effectiveness of single-photon emission computed tomography/computed tomography (SPECT/CT) in detecting and localizing the causative vertebra in cases of suspected fresh osteoporotic vertebral compression fractures (OVCFs) in patients with contraindications to MRI.
Methods
A total of 21 patients with severe back pain with 31 suspected OVCF segments and contraindications to MRI were initially identified through radiographs and the back pain-inducing test (BPIT). The responsible vertebral bodies were determined using [99mTc]MDP SPECT/CT before percutaneous vertebroplasty (PVP). Clinical outcomes and radiographic parameters, including basic demographics, injury duration, focal kyphosis (FK), loss of vertebral height (LVH), and relative intensity values (RIVs) for target and nontarget segments in the SPECT/CT were measured.
Results
SPECT/CT identified 14 old and 26 fresh OVCFs. Of these, 18 patients with 26 fresh OVCF segments underwent PVP, and achieved satisfactory outcomes. Significant differences were observed in the RIV, FK, and LVH values between the fresh and old OCVF groups (all p < 0.05). RIVs showed a significant negative correlation with injury duration (r = −0.57, p < 0.05), and a positive correlation with LVH (r = 0.43, p < 0.05). Multiple linear regression analysis confirmed that injury duration was an independent predictor of RIVs (p < 0.05).
Conclusion
SPECT/CT is useful for detecting and differentiating fresh fractures from old fractures in patients having OVCF who cannot undergo MRI after BPIT validation, allowing these patients to achieve excellent clinical outcomes following PVP. The RIV serves as a valuable parameter for assessing the duration of fresh versus old OVCFs.
期刊介绍：
Clinical Physiology and Functional Imaging publishes reports on clinical and experimental research pertinent to human physiology in health and disease. The scope of the Journal is very broad, covering all aspects of the regulatory system in the cardiovascular, renal and pulmonary systems with special emphasis on methodological aspects. The focus for the journal is, however, work that has potential clinical relevance. The Journal also features review articles on recent front-line research within these fields of interest.
Covered by the major abstracting services including Current Contents and Science Citation Index, Clinical Physiology and Functional Imaging plays an important role in providing effective and productive communication among clinical physiologists world-wide.
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