Diagnostic value of SPECT versus SPECT/CT in femoral avascular necrosis

Luk, Wing Hang; Au-Yeung, Andrea Wai San; Yang, Michael K. W.

doi:10.1097/mnm.0b013e32833e7732

Cited by 27 publications

(16 citation statements)

References 11 publications

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“…More diffuse in-creased radionuclide activity is usually present in epiphyseal involvement with articular collapse and secondary osteoarthritis. The addition of single-photon-emission computed tomography (SPECT) may improve the accuracy of radionuclide imaging for diagnosis of ON (18,19). In a study by Ryu and colleagues (19), SPECT was determined to be more sensitive than MR imaging (100% vs 66%) in detecting early ON following renal transplantation.…”

Section: Imaging Of Adult Osteonecrosismentioning

confidence: 99%

From the Radiologic Pathology Archives Imaging of Osteonecrosis: Radiologic-Pathologic Correlation

Murphey¹,

Foreman²,

et al. 2014

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Osteonecrosis is common and represents loss of blood supply to a region of bone. Common sites affected include the femoral head, humeral head, knee, femoral/tibial metadiaphysis, scaphoid, lunate, and talus. Symptomatic femoral head osteonecrosis accounts for 10,000-20,000 new cases annually in the United States. In contradistinction, metadiaphyseal osteonecrosis is often occult and asymptomatic. There are numerous causes of osteonecrosis most commonly related to trauma, corticosteroids, and idiopathic. Imaging of osteonecrosis is frequently diagnostic with a serpentine rim of sclerosis on radiographs, photopenia in early disease at bone scintigraphy, and maintained yellow marrow at MR imaging with a serpentine rim of high signal intensity (double-line sign) on images obtained with long repetition time sequences. These radiologic features correspond to the underlying pathology of osseous response to wall off the osteonecrotic process and attempts at repair with vascularized granulation tissue at the reactive interface. The long-term clinical importance of epiphyseal osteonecrosis is almost exclusively based on the likelihood of overlying articular collapse. MR imaging is generally considered the most sensitive and specific imaging modality both for early diagnosis and identifying features that increase the possibility of this complication. Treatment subsequent to articular collapse and development of secondary osteoarthritis typically requires reconstructive surgery. Malignant transformation of osteonecrosis is rare and almost exclusively associated with metadiaphyseal lesions. Imaging features of this dire sequela include aggressive bone destruction about the lesion margin, cortical involvement, and an associated soft-tissue mass. Recognizing the appearance of osteonecrosis, which reflects the underlying pathology, improves radiologic assessment and is important to guide optimal patient management.

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Section: Imaging Of Adult Osteonecrosismentioning

confidence: 99%

From the Radiologic Pathology Archives Imaging of Osteonecrosis: Radiologic-Pathologic Correlation

Murphey¹,

Foreman²,

et al. 2014

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“…When CT is added, fusion images known as SPECT/CT can be created, containing both physiologic information from the SPECT and anatomic information from the CT (Fig. 5), and the diagnostic capability of AVN is improved over SPECT alone [29]. With MRI, the sensitivity and specificity increase compared with planar bone scintigraphy [30,31], but no reports have compared SPECT/CT with MRI in AVN of the hip.…”

Section: Discussionmentioning

confidence: 99%

Vascular evaluation after cervical hip fractures in children

Juréus¹,

Geijer

Tiderius³

et al. 2016

Journal of Pediatric Orthopaedics B

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Femoral neck fractures in children and young adults are rare, but have a high risk of avascular necrosis (AVN) and subsequent gradual collapse of the femoral head. In 2006, we initiated the use of scintigraphy for the diagnosis of vascular impairment after a cervical fracture in children. In the present retrospective case study, we evaluated the effect of the remaining postoperative circulation in the femoral head after fracture in terms of the development of AVN and secondary degenerative changes of the hip joint. Eight children, four girls and four boys [mean age 11.5 years (7-16)], had been operated for a cervical or a basocervical hip fracture between 2006 and 2012. The femoral head circulation was evaluated postoperatively with scintigraphy and all children had been followed radiographically for a minimum of 1 year. The Ficat classification was used to stage the AVN and the Stulberg classification was used to stage the sphericity of the femoral head at follow-up. In two patients, the femoral head had normal circulation postoperatively and they also had normal radiographs at follow-up. In two patients, the entire femoral head was avascular postoperatively and at follow-up, one patient had normal radiographs and one had both subchondral sclerosis and flattening. These two patients had been treated with bisphosphonates and prolonged non-weight-bearing. Four patients had postoperatively retained circulation in parts of the femoral head. Three of these four patients had normal radiographs at follow-up. Evaluation of the remaining circulation after surgery may help to predict the outcome and guide the postoperative regime in children with a femoral neck fracture.

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“…У пацієнтів із протипоказаннями до МРТ та металевими імплантатами зазвичай застосовують ОФЕКТ/ КТ, що має дуже добрі діагностичні властивості для діагностики аваскулярного некрозу головки стегнової кістки порівняно з ОФЕКТ-візуалізацією (рис. 2г) [30].…”

Section: аваскулярний некроз головки стегнової кісткиunclassified

Роль Гібридної Офект/Кт-Візуалізації В Діагностичному Моніторингу Пацієнтів Із Патологією Кісток Нижніх Кінцівок (Огляд Літератури)

Korol¹,

Ткаченко²

2021

TRAUMA

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В огляді літератури розглянуто ключові питання клінічного застосування гібридної ОФЕКТ/КТ-візуалізації у хворих з ураженнями кісток нижніх кінцівок. Розвиток гібридної візуалізації здійснив революцію в діагностиці хворих із широким спектром патологічних процесів кісток нижніх кінцівок на всіх етапах розвитку та відіграє важливу роль у сучасному моніторингу пацієнтів. Синтез функціональної інформації, отриманої за допомогою ОФЕКТ у комплексі з КТ із високою роздільною здатністю, дозволяє ефективно діагностувати патологічний метаболізм в ураженій ділянці кістки з одночасною оцінкою співіснуючих структурних змін.

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Diagnostic value of SPECT versus SPECT/CT in femoral avascular necrosis

Abstract: We concluded that SPECT/CT is beneficial for the improvement of AUC in ROC on the diagnostic of hip AVN compared with SPECT alone.

Cited by 27 publications

References 11 publications

From the Radiologic Pathology Archives Imaging of Osteonecrosis: Radiologic-Pathologic Correlation

From the Radiologic Pathology Archives Imaging of Osteonecrosis: Radiologic-Pathologic Correlation

Vascular evaluation after cervical hip fractures in children

Роль Гібридної Офект/Кт-Візуалізації В Діагностичному Моніторингу Пацієнтів Із Патологією Кісток Нижніх Кінцівок (Огляд Літератури)

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