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| JIANG Xiaobing,LUO Yaowu,LIANG De.The value of SPECT-CT fusion image in selection of target vertebrae for percutaneous vertebral augmentation for the aged patients of vertebral compression fracture[J].Chinese Journal of Spine and Spinal Cord,2012,(4):330-334. |
| The value of SPECT-CT fusion image in selection of target vertebrae for percutaneous vertebral augmentation for the aged patients of vertebral compression fracture |
| Received:January 10, 2012 Revised:February 18, 2012 |
| English Keywords:Vertebral compression fracture Single photon emission computed tomography and computer tomography Fusion image Percutaneous vertebrae augmentation Target vertebrae |
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| 【Abstract】 Objectives: To analyze the value of single photon emission computed tomography and computer tomography（SPECT-CT） fusion image in selection of target vertebrae for percutaneous vertebral augmentation for the aged patients of vertebral compression fracture. Methods: 4 elderly cases suffering from vertebral compression fracture from June 2010 to April 2011 were reviewed retrospectively, all cases were not suitable for MRI due to paramagnetic metal instrument in their bodies previously. The SPECT-CT fusion image was used as alternative to MRI. The whole skeletal image of SPECT was performed by Infinia Hawkeye 4 machine, then CT scan was performed to evaluate the area of interest by the same machine and the fusion image of SPECT and CT was finished by fusion image software. The lesion vertebrae were determined based on the area of nuclide accumulation in the whole skeletal image of SPECT, then the clinical diagnosis of osteoporosis vertebral compression fracture(OVCF) was confirmed by excluding the probability of neoplasm or infection after analyzing the CT image of local bone lesion, and the target vertebrae for percutaneous vertebral augmentation were located clearly by SPECT-CT fusion image. There were 1 male and 3 females, with the mean age of 67.4 years(59-79 years) and mean duration of 17 days(8-60 days). All cases were not suitable for MRI due to implanted paramagnetic metal instrument including coronary artery metal stent in 2 cases, heart metal pacemaker in 1 case and artificial femur head made of stainless steel in 1 case. The clinical outcomes were evaluated by visual analog scale(VAS) and Oswestry disability index(ODI) at preoperation and 2 days after operation. All cases accepted radiographic examination in follow-up to exclude the spinal neoplasm and in?鄄fection. Results: Based on the SPECT-CT fusion image, nuclide accumulation was found in 1 segment of 3 cases, 2 segments of 1 case. The lesions included T12 in 2 cases, L1 in 1 case, L2 in 1 case and L3 in 1 case. No spinal neoplasm and infection were noted in CT scan. The VAS scores and ODI in baseline was 8-9 and 80%-90% at preoperation respectively; while 1.5-2.5 and 20%-30% for 2 days after operation, which showed significant improvement. During the average follow-up of 10 months, spinal neoplasm and infection were not noted. Conclusions: For the aged patients of vertebral compression fracture who are unsuitable for accepting MRI examination, SPECT-CT fusion image can be used to locate clearly the lesion vertebrae and determine the clinical diagnosis of OVCF by analyzing the bone structure in the area of nuclide collection; SPECT-CT fusion image is useful for selection of the target vertebrae for percutaneous vertebral augmentation. |
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