摘要
目的探讨骨三相显像对人工关节置换术后松动与感染的鉴别诊断价值。方法 2010年6月至2012年1月在我科行骨三相显像的人工关节置换术后患者共107例,经随访具有手术病理或穿刺病理明确诊断的共77例,人工置换关节共81个。77例患者男31例,女46例,年龄32～75岁,平均61.7岁。在81个人工置换关节中,最后经手术病理证实为松动的关节共40个。经病理证实为感染的共41个关节。在40个手术病理证实为松动的人工关节中有9个关节病理诊断为松动伴有炎性肉芽肿,其中7个为髋关节、2个为膝关节。结果 81个关节中经手术病理证实为松动的人工关节共40个,骨三相诊断为松动的关节共34个,假阴性为6个,符合率为85.0%;最后确诊为感染的关节共有41个,骨三相诊断为感染的关节为38个,假阴性有3个,符合率达92.6%。结论骨三相显像判断假体松动有很高的灵敏度,并可以明确病变部位,对手术有指导意义,对感染的诊断符合率高,因此骨三相在鉴别人工关节术后感染与松动有很高的临床价值。但骨三相对于松动合并感染的判断尚有一定难度,尚需深入研究和总结。
Objective To explore the clinical significance of triple-phase bone scintigraphy in the diagnosis of loosening and infection after arthroplasty. Methods A total of 107 eases received triple-phase bone scintigraphy from June 2010 to January 2012. Eighty-one joints of 77 cases were diagnosed by the puncture or operation pathology. There were 31 males and 46 females, with an average age of 61.7 （32-75）years. In the 81 joints, 40 joints were diagnosed as joint loosening by operation pathology, and 9 of them was combined with inflammatory granuloma（7 were hip joints and 2 were knee joints）. Forty-one joints were diagnosed as joint infection. Results There were 34 joints that was diagnosed as joint loosening by triple-phase hone scintigraphy in the dO joints that were confirmed by operation pathology, the diagnosis coincidence rate was 85. 0% ;and there were 38 joints that was diagnosed as joint infection in the 41 joints with joint infection,the diagnosis coincidence rate was 92. 6%. Conclusions Tiple-phase bone scintigraphy is a high sensitivity method to diagnose joint loosening. There is a high coincidence rate when loosening combined with infection. So there is a high clinical signifieance of triple-phase bone seintigraphy in the diagnosis of joint loosening and infection after arthroplasty, however it is difficult to differentiate loosening from infection.
出处
《中华临床医师杂志（电子版）》
CAS
2013年第2期92-94,共3页
Chinese Journal of Clinicians(Electronic Edition)
关键词
放射性核素显像
人工关节
假体相关感染
假体植入
Radionuclide imaging
Joint prosthesis
Prosthesis-related infections
Prosthesis implantation
作者简介
通讯作者：朱瑞森，Email：zhurs33@hotmail．com.
