SPECT/CT versus MRI in patients with nonspecific pain of the hand and wrist – a pilot study
| Autor: | Urs von Wartburg, Maja Schürch, Klaus Strobel, Florian S. Schleich, Martin W. Huellner, U. Hug, Patrick Veit-Haibach, Alexander Bürkert |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Radiography Pain Pilot Projects Wrist Single-photon emission computed tomography Wrist pain Multimodal Imaging Young Adult medicine Edema Humans Radiology Nuclear Medicine and imaging Radioactive Tracers Bone Marrow Diseases Aged Retrospective Studies medicine.diagnostic_test business.industry Chronic pain Biological Transport Magnetic resonance imaging General Medicine Middle Aged Hand medicine.disease Magnetic Resonance Imaging body regions medicine.anatomical_structure Positron emission tomography Positron-Emission Tomography Orthopedic surgery Female Radiology medicine.symptom Tomography X-Ray Computed business |
| Zdroj: | European Journal of Nuclear Medicine and Molecular Imaging. 39:750-759 |
| ISSN: | 1619-7089 1619-7070 |
| Popis: | Hand and wrist pain is a diagnostic challenge for hand surgeons and radiologists due to the complex anatomy of the involved small structures. The American College of Radiology recommends MRI as the study of choice in patients with chronic wrist pain if radiographs are negative. Lately, state-of-the-art SPECT/CT systems have been introduced and may help in the diagnosis of this selected indication.This retrospective study included 21 patients with nonspecific pain of the hand/wrist. The diagnosis of nonspecific wrist pain was made by the referring hand surgeon based on patient history, clinical examination, plain radiography and clinical guidelines. All patients received planar early-phase imaging and late-phase SPECT/CT imaging as well as MRI. Lesions were divided into major (causative) and minor (not causative) pathologies according to clinical follow-up. Furthermore, oedema-like bone marrow changes seen on MRI were compared with focally increased tracer uptake seen on SPECT/CT images.MRI yielded a quite high sensitivity (0.86), but a low specificity (0.20). In contrast, SPECT/CT yielded a high specificity (1.00) and a low sensitivity (0.71). Oedema-like bone marrow changes were detected in 15 lesions in 11 patients. In ten lesions with bone marrow oedema on MRI, foci of elevated tracer uptake were detected on SPECT/CT. Overall, MRI was more sensitive, but SPECT/CT was more specific in the evaluation of causative pathologies.In this initial comparison, SPECT/CT showed higher specificity than MRI in the evaluation of causative pathologies in patients with nonspecific wrist pain. However, MRI was more sensitive. Thus, SPECT/CT was shown to be a useful problem-solving tool in the diagnostic work-up of these patients. |
| Databáze: | OpenAIRE |
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