99Tcm-MDP SPECT/CT诊断钳夹型髋关节撞击综合征

目的 探讨⁹⁹Tc^m-MDP SPECT/CT诊断钳夹型髋关节撞击综合征（FAI）的价值。方法 对临床疑似钳夹型FAI的85例患者（共96个发病髋关节）行⁹⁹Tc^m-MDP SPECT/CT检查，并进行图像分析。最终由手术或6个月以上的随访资料确诊。分别计算CT、SPECT和SPECT/CT评价钳夹型FAI的诊断效能，并进行统计学分析。结果 96个髋关节中，临床最终确诊有钳夹型FAI 87个。CT、SPECT和SPECT/CT显像对钳夹型FAI的诊断灵敏度分别为77.01%（67/87）、95.56%（84/87）、95.56%（84/87），特异度分别为44.44%（4/9）、100%（9/9）、100%（9/9），准确率分别为73.95%（71/96）、96.88%（93/96）、96.88%（93/96）。三种方法诊断钳夹型FAI的灵敏度、特异度和准确率差异均有统计学意义（P均<0.01），SPECT/CT融合显像和SPECT显像之间差异均无统计学意义（P均>0.05），SPECT/CT或SPECT显像与CT检查间差异均有统计学意义（P均<0.01）。结论 ⁹⁹Tc^m-MDP SPECT/CT可灵敏、准确地诊断钳夹型FAI，值得临床推广。

99Tcm-MDP SPECT/CT in diagnosis of pincer femoroacetabular impingement syndrome

Objective To evaluate the value of ⁹⁹Tc^m-MDP SPECT/CT in diagnosing pincer femoroacetabular impingement (FAI) syndrome. Methods Totally 85 patients with 96 hips suspected of pincer FAI syndrome underwent ⁹⁹Tc^m-MDP SPECT/CT examinations. The final diagnosis were confirmed by surgery or 6 months follow-up. The diagnostic efficacy of CT, SPECT and SPECT/CT were evaluated and the statistical analysis was performed. Results Eighty-seven hips were diagnosed as pincer FAI. The diagnostic sensitivity of CT, SPECT and SPECT/CT were 77.01% (67/87), 95.56% (84/87), 95.56% (84/87). The diagnostic specificity of CT, SPECT and SPECT/CT were 44.44% (4/9), 100% (9/9), 100% (9/9). The diagnostic accuracy of CT, SPECT and SPECT/CT were 73.95% (71/96), 96.88% (93/96), 96.88% (93/96). The sensitivity, specificity and accuracy had statistically significant difference among the three methods (all P<0.01), which had no statistically significant difference between the SPECT/CT and SPECT (all P>0.05), and had statistically significant difference between the SPECT/CT or SPECT and CT (all P<0.01). Conclusion ⁹⁹Tc^m-MDP SPECT/CT can accurately and sensitively diagnose pincer FAI.