The Value of Quantitative Uptake of 99mTc-MDP and 99mTc-HMPAO White Blood Cells in Detecting Osteomyelitis in Violated Peripheral Bones
| Autor: | Shihab Al-Mohannadi, Fawaz Abu Al-Huda, Haider Ali Khan, Hanan Mahmood, Nasser S. Ballani, Farha Al-Enezi |
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| Rok vydání: | 2007 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Technetium Tc 99m Medronate Sensitivity and Specificity Prosthesis Technetium Tc 99m Exametazime Knee prosthesis Leukocytes medicine Humans Radiology Nuclear Medicine and imaging Radionuclide Imaging Aged Traumatic fracture Radiological and Ultrasound Technology Acute osteomyelitis business.industry Osteomyelitis Reproducibility of Results General Medicine Middle Aged medicine.disease 99mTc-HMPAO Diabetic foot Peripheral Female Radiology Radiopharmaceuticals business Nuclear medicine |
| Zdroj: | Journal of Nuclear Medicine Technology. 35:91-95 |
| ISSN: | 0091-4916 |
| DOI: | 10.2967/jnmt.106.035402 |
| Popis: | Our objective in this study was to evaluate whether measurement of quantitative uptake of 99mTc-methylene diphosphate (MDP) and 99mTc-hexamethylpropyleneamine oxime (HMPAO) white blood cells (WBCs) is useful in detecting osteomyelitis in peripheral bony lesions. Methods: Twenty-four patients (12 men and 12 women; age range, 25–72 y) were referred for imaging because of clinically suspected osteomyelitis. They had a traumatic fracture (n = 10), knee prosthesis (n = 5), hip prosthesis (n = 2), diabetic foot (n = 4), or chronic osteomyelitis (n = 3). Three-phase bone scanning and 99mTc-HMPAO WBC studies were performed on all patients within the same week. Regions of interest were drawn over the abnormal bony sites and the contralateral normal sites, and the abnormal-to-normal uptake ratios (A/N ratios) were obtained for both studies. Results: All patients had abnormal findings on 3-phase bone scanning, whereas 17 (71%) had abnormal findings on 99mTc-HMPAO WBC studies, of which 15 were confirmed to be true-positive. In those 15 patients, the mean A/N ratios for 99mTc-MDP and 99mTc-HMPAO WBC were 3.0 ± 1.6 (range, 1.3–6.2) and 1.8 ± 0.3 (range, 1.4–2.2), respectively. In the other 9 patients, whose scan results were clinically confirmed to be true-negative, the mean A/N ratios for 99mTc-MDP and 99mTc-HMPAO WBC were 2.1 ± 1.2 and 1.2 ± 0.2, respectively. In the group with a 99mTc-MDP A/N ratio greater than 2 (n = 15), 87% (13/15) had a high 99mTc-HMPAO WBC A/N ratio (>1.5), including 2 that were false-positive. In the remaining 2 patients, one with chronic osteomyelitis and the other with a recent hip prosthesis, 99mTc-HMPAO WBC ratios were normal. In the group with a bone A/N ratio of less than 2 (n = 9), only 4 patients (44%) were true-positive for acute osteomyelitis. Conclusion:99mTc-MDP bone scanning alone, with an A/N ratio of more than 2, is useful in detecting osteomyelitis in violated bone except in the case of a recent hip prosthesis or chronic osteomyelitis. |
| Databáze: | OpenAIRE |
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