Abstract
307
Objectives: To assess the added diagnostic value of 99mTc-MDP SPECT/CT bone imaging by semi-quantitative analysis indexes for distinguishing osteoporotic thoracolumbar old vertebral fractures and fresh vertebral fractures in postmenopausal women.
Methods: Eighty-one postmenopausal women patients with back pain, diagnosed and treated in our hospital from November 2012 to October 2016, were enrolled in this retrospective study. All the patients were diagnosed as osteoporotic thoracolumbar vertebral compression fractures. All the patients underwent 99mTc-MDP SPECT/CT bone imaging, and application ROI techniques repeatedly was used to draw the sagittal imaging site of the regional uptake in regions of interest (ROI), recording the number radioactivecountings of lesions(T) and adjacent normal vertebral sagittal imaging(N), then calculating the T/N ratio. All the images were independently diagnosed and analysed by two physicians of nuclear medicine.
Results: One hundred and ten fresh vertebral fractures and seventy old vertebral fractures were diagnosed by 99mTc-MDP SPECT/CT bone imaging. T/N ratio of fresh fractures and old fractures were 2.44±0.84 and 1.04±0.14, respectively (P<0.05). When the osteoporotic vertebral fracture T/N ratio was 1.36 through the ROC curve analysis,it was the best critical value to distinguish osteoporotic thoracolumbar old vertebral fractures and fresh vertebral fractures in postmenopausal women.The sensitivity and specificity respectively were 94.5%, 100%.In addition, some other concurrent lesions which are absent in X-ray or MRI was find by SPECT/CT, for example rib fracture, sacrum fracture.
Conclusion: 99mTc-MDP SPECT/CT bone imaging by semi-quantitative analysis could effectively identify fresh and old vertebral fracture, providing an another method for patients to diagnose vertebral fracture. SPECT/CT enables more accurate localization of tracer accumulation, especially in anatomic regions that are otherwise difficult to interpret because of complex skeletal architecture. At the same time, some other concurrent lesions which are absent in X-ray or MRI could be find by SPECT/CT, such as rib fracture, sacrum fracture. Research Support: bone imaging; osteoporosis; vertebral fracture; semi-quantitative analysis