The Clinical Value Of SPECT/CT In The Management Of Avascular Necrosis Of The Femoral Head

Objective To investigate clinical value of the combined SPECT and CT in diagnosing avascular necrosis of the femoral head from imaging fusion, bone dynamic imaging and bone mineral density densitometry three aspects.Methods 80 patients dubiously diagnosed avascular necrosis of the femoral head as study group and 10 patients with lumbar disc herniation or rheumatoid arthritis or ankylosing spondylitis as disease control group underwent bone dynamic imaging ,whole body and SPECT/CT bone scan. As while as CT bone scan bone mineral density densitometry was proceed. 40 persons as normal control group were performed bone dynamic imaging, whole body bone scan and bone mineral density densitometry.Results These sensitivity of fusion image in diagnose of avascular necrosis of the femoral head was higher than tomography image and planar image (99.0% vs 96.0% vs91.1%, P<0.05) ,and the specificity of fusion image was higher than tomography image and planar image (94.1%vs 88.2% vs82.4%, P<0.05). The nuclide uptake ratio of femoral head and abdominal aorta and iliac artery in study group had no significant difference with that of normal control group. In early stage the nuclide uptake ratio of femoral head and branch in study group had no significant difference with that of normal control group, but in middle and late stage the nuclide uptake ratio in study group was higher than that of normal control group. The lumbar and proximal femur cancellous bone mineral density of study group was significantly lower than that of normal control group.Conclusion Combined SPECT and CT can reflect the change of the femoral head hemodynamics, metabolize, configuration and bone mineral density, so it can help osteonecrosis of the femoral head early diagnosing ,distinguishing, staging, prognosticating and supervising therapy.