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| JIANG Xiaobing,MO Ling,YAO Zhensong.The value of SPECT, SPECT-CT and MRI in the diagnosis of fresh osteoporotic vertebral compressive fracture[J].Chinese Journal of Spine and Spinal Cord,2013,(10):891-897. |
| The value of SPECT, SPECT-CT and MRI in the diagnosis of fresh osteoporotic vertebral compressive fracture |
| Received:December 11, 2012 Revised:March 28, 2013 |
| English Keywords:Osteoporosis vertebral compressive fracture Single photon emission computed tomography Single photon emission computed tomography and computer tomography Magnetic resonance imaging |
| Fund:卫生部医药卫生科技发展研究中心资助课题（编号：W2012ZT07）；广州中医药大学2012年优秀青年科研基金项目 |
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| English Abstract: |
| 【Abstract】 Objectives: To explore the values of single photon emission computed tomography(SPECT), single photon emission computed tomography and computer tomography(SPECT-CT) and magnetic resonance imaging(MRI) in the diagnosis of fresh osteoporotic vertebral compressive fracture(OVCF). Methods: Between October 2011 and April 2012, 20 elder patients suffering from vertebral compressive fracture and undergoing MRI, SPECT, SPECT-CT were analyzed retrospectively. There were 12 females and 8 males, with an average age of 73.5 years(60-80 years), and their average disease duration was 21 days. The diagnosis was based on MRI findings, with bone marrow edema defined as fresh OVCF, and the compressed vertebra without bone marrow edema was defined as old OVCF. Then SPECT bone imaging and hybrid SPECT-CT were performed respectively by 2 independent nuclear physicians to determine the specific level and diagnosis based on nuclear accumulation. The consistency about the ability of between SPECT-CT and MRI in discriminating fresh or old OVCF was analyzed by Kappa test. According to the findings of MRI, the ability of SPECT-CT and SPECT was compared between by Chi-square test. Results: Based on MRI or SPECT-CT, all patients were diagnosed as fresh OVCF, which included 32 levels in MRI and 34 in SPECT-CT, while for SPECT, only 12 patients were diagnosed as fresh OVCF, the others were suspected as fresh OVCF, but tumor or infection could not be excluded. 32 fresh OVCF and 10 old OVCF were found by MRI, and 34 fresh OVCF and 8 old OVCF were found by SPECT-CT, there was good consistency between them(Kappa=0.0577, P<0.05). As for the accuracy of locating lesion determined by MRI, 24 segments in SPECT and 30 segments in SPECT-CT were in accordance with the findings of MRI respectively, SPECT-CT had higher accuracy than SPECT(24 VS 30, P<0.05). Additionally, some concurrent bone lesions including sacral coccygeal vertebral fracture(1 case), rib fractures(2 cases), the inflammation of sacroiliac articulation(1 case) and benign lesion in sterno-clavicular articulation(1 case), which were absent in MRI were found by SPECT and SPECT-CT. Conclusions: SPECT-CT has the similar ability in diagnosing the fresh OVCF as MRI and has better accuracy of localizing lesion than traditional SPECT. Some other concurrent lesions which are absent in MRI can be found by SPECT-CT. Conclusively, SPECT-CT is a reliable alternative when MRI is unsuitable. |
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