The Korean Journal of Nuclear Medicine (대한핵의학회지)
- Volume 33 Issue 4
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- Pages.405-412
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- 1999
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- 1225-6714(pISSN)
The Usefulness of Postoperative Pinhole Bone Scintigraphy in the Assessment of Prognosis after Multiple Drilling or Vascularized Bone Graft in Patients with Avascular Necrosis of Femoral Head
다발성 천공술 및 혈관 부착 골이식술을 시행한 대퇴골두 무혈관성 괴사의 예후: 수술 후 바늘구멍 골신티그라피의 유용성
- Chung, Yong-An (Department of Radiology, The Catholic University of Korea) ;
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Kim, Sung-Hoon
(Department of Radiology, The Catholic University of Korea) ;
- Chun, Kyung-Ah (Department of Radiology, The Catholic University of Korea) ;
- Park, Young-Ha (Department of Radiology, The Catholic University of Korea) ;
- Sohn, Hyung-Seon (Department of Radiology, The Catholic University of Korea) ;
- Chung, Soo-Kyo (Department of Radiology, The Catholic University of Korea) ;
- Song, Mun-Kab (Department of Radiology, Eulji Medical Center)
- 정용안 (가톨릭대학교 의과대학 방사선과학교실) ;
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김성훈
(가톨릭대학교 의과대학 방사선과학교실) ;
- 천경아 (가톨릭대학교 의과대학 방사선과학교실) ;
- 박영하 (가톨릭대학교 의과대학 방사선과학교실) ;
- 손형선 (가톨릭대학교 의과대학 방사선과학교실) ;
- 정수교 (가톨릭대학교 의과대학 방사선과학교실) ;
- 송문갑 (을지대학병원 진단방사선과)
- Published : 1999.08.30
Abstract
Purpose: It is important to evaluate the healing process of avascular necrosis (AVN) involving femoral head after treatment. The purpose of this study was to assess the usefulness of pinhole bone scintigraphy in the AVN of femoral head after surgery. Materials and Methods: We analyzed the changing pattern of pinhole bone scintigram in 21 femoral heads of 16 patients (14 lesions/11 male, 7 lesions/5 female, mean age: 39.4 yrs) before and after multiple drilling or vascularized bone grafting for AVN of the femoral head. In all patients, pre-operative scintigrams were obtained at 1 to 3 months before treatment and the first post-operative scintigrams were obtained at 1 to 3 months after treatment. All patients were followed for 2 to 4 years after operation. Results: The findings of the pinhole scintigrams were divided into three patterns: 1) curvilinear, 2) scattered spotty and 3) undetermined. The 10 of 11 lesions with curvilinear pattern had good postoperative clinical and radiological follow-up findings. However, all 6 lesions with scattered spotty pattern showed poor postoperative findings, which necessitated total hip joint replacement. Of the 4 lesions with undetermined pattern, 2 required total hip joint replacement. There was significant difference in postoperative prognosis between the curvilinear and scattered spotty patterns (p<0.05). Conclusion: We conclude that the pattern of pinhole bone scintigram obtained within 1 to 3 months after multiple drilling or vascularized bone graft operation is a useful prognostic indicator in the AVN of femoral head.
목적: 대퇴골두의 무혈관성괴사에서 치료 후 치유되는 과정의 평가는 매우 중요하다. 그러나 무혈관성괴사의 치료에 대한 병리학적 변화를 단순방사선 촬영만으로 평가하기에는 어려움이 있다. 이에 저자들은 무혈관성괴사에서 바늘구멍 골신티그라피 소견과 병변의 치유과정과의 관계에 대해 비교 분석하였다. 대상 및 방법: 조직학적으로 대퇴골두 무혈관성 괴사로 진단된 환자 16명의 21예의 대퇴골두 병소(남자: 11명 14예, 여자. 5명 7예, 평균나이: 39.4 세)를 대상으로 하였다. 다발성 천공술은 14예, 혈관부착 골이식술은 7예에서 시행하였다. 바늘구멍 골신티그라피를 얻었고, 골신티그라피는 치료 전 1-3개월 사이에, 수술 후 첫 번째 검사는