• 대한족부족관절학회지
• /
• 제6권2호
• /
• pp.172-177
• /
• 2002

Objectives: To validate usefulness of the three phase bone scan for the diagnosis of osteomyelitis in the diabetic foot with soft tissue inflammation. Materials and Methods: Fourteen diabetic feet with soft tissue inflammation were included in this study. We took the bone biopsy from the site of hot uptake on the three phase bone scan but no abnormal findings on the plain radiographs. We observed whether the bone has evidence of osteomyelitis on the patholgic findings such as inflammatory cell infiltration within bone, dead bone, new bone formation and fibrosis. Results: Thirteen of fourteen cases (92.8%) were compatible with osteomyelitis on the pathologic criteria. Inflammatory cell infiltration within bone was observed in thirteen cases, dead bone in twelve cases. new bone formation in four cases. fibrosis in eight cases. All of the four findings were observed in three cases. Conclusion: In the diabetic foot with soft tissue inflammation, the osteomyelitis should be included in differential diagnosis if the lesion reveals increased uptake on three phase bone scan, even though the lesion does not show any abnormal findings on the plain radiographs.

• 대한핵의학회지
• /
• 제37권6호
• /
• pp.428-436
• /
• 2003

목적: 암환자의 추적 골스캔에서 관절주위 섭취증가를 보이는 경우 관절염 이외의 원인으로 말초골수 확장에 의한 이차적 골섭취 증가를 생각할 수 있다. 이 때 막초골수 확장의 원인으로. 즉 중심골수 침범에 의한 이차적 말초골수 확장과 만성빈혈에의한 이차적 골수확장의 감별에 골스캔상 전신골섭 취계수 증가 소견이 도움을 주는지 알아보기 위해 본 연구에서는 암환자의 골스캔상 관절주위 섭취증가 소견을 보인 12명의 환자에서 골스캔과 골수스캔 소견을 비교 분석하였다. 대상 및 방법: 추적 골스캔에서 관절주위 섭취증가를 보인 12명의 암환자에서 1 주일 이내에 Tc-99m colloid 골수스캔을 시행하였다. 골스캔상 전신골섭취계수 증가 여부를 알아보고 골수스캔에서는 중심골 섭취감소 여부와 말초골수 확장여부를 각각 알아 보았다. 임상적으로 관절염, 관절통 여부와 빈혈이 동반되는지 알아 보았다. 결과: 원발암의 진단명은 혈액암 5례, 위암 3례, 유방암 2례, 전립선암 1례, 폐암 1례였다. 남녀비는 7:5 이고 평균연령은 47.5 14.3세였다. 골스캔에서 전신골섭취계수 증가는 3례에서 관찰되었으며 모두 골수스캔상 중심골수 섭취감소 소견과 말초골수 확장 소견을 보여 전신 골수전이로 진단되었다. 골스캔상 전신골섭취계수 증가를 보이지 않았던 9례 중 1례는 중심골수 섭취가 감소되고 말초골수가 확장되었으며 만성골수성백혈병의 급성기로 진단되었다. 7례는 중심골수 섭취는 정상이었고 말초골수 확장이 관찰되었으며 빈혈이 동반되어 있어 악성질환의 만성빈혈로 추정되었다. 결론: 암환자의 추적 골스캔에서 관절주위 섭취증가와 함께 전신골섭취계수가 증가된 경우 전신 골수전이에 의한 이차적 말초골수 확장을 고려해야 하며 이의 감별진단에 골수스캔이 유용한 검사이다.

• 대한핵의학회지
• /
• 제21권2호
• /
• pp.213-219
• /
• 1987

Although the exact mechanism is not clearly understood yet, there were examples of the uptake of radiopharmaceuticals to the soft tissue lesions with $^{99m}Technetium$ methylene diphosphonate bone scan. Recently, we experienced two cases of neuroblastoma of which primary sites were imaged with $^{99m}Tc-MDP$ bone scan preoperatively and could make the diagnosis. So, we report here that $^{99m}Tc-MDP$ bone scan is the reasonable method not only to find out the bone metastasis, but also to diagnose the neuroblastoma preoperatively.

• Imaging Science in Dentistry
• /
• 제41권2호
• /
• pp.59-62
• /
• 2011

Purpose : This study was performed to evaluate the changes of jaw bone density around the dental implant after placement using computed tomography scan (CT-Scan). Materials and Methods : This retrospective study consisted of 30 patients who had lost 1 posterior tooth in maxilla or mandible and installed dental implant. The patients took CT-Scan before and after implant placement. Hounsfield Unit (HU) was measured around the implants and evaluated the difference of HU before and after implant installation. Results : The mean HU of jaw bone was 542.436 HU and 764.9 HU before and after implant placement, respectively (p<0.05). The means HUs for male were 632.3 HU and 932.2 HU and those for female 478.2 HU and 645.5 HU before and after implant placement, respectively (p<0.05). Also, the jaw bone with lower density needed longer period for implant procedure and the increased change of HU of jaw bone was less in the cases which needed longer period for osseointegration. Conclusion : CT-Scan could be used to assess the change of bone density around dental implants. Bone density around dental implant was increased after placement. The increased rate of bone density could be determined by the quality of jaw bone before implant placement.

• 대한핵의학회지
• /
• 제28권3호
• /
• pp.384-390
• /
• 1994

악성 종양의 척추 전이를 진단하는 데 bone scan과 MRI의 소견을 비교하여 보았다. 20명의 악성 종양환자를 대상으로 하였으며 환자의 평균 연령은 60.1 세였고 두 검사의 시행 간격은 평균 16.6일 이었다. 원발암은 폐암이 8명으로 가장 많았고 대장암, 위암, 유방암이 각각 2명, 전립선암, 갑상선암, 악성 임파종이 각각 1명이었으며 3명은 원발 장소를 모르는 전이성 선암 환자였다. 방법으로 척추를 7개의 구역 즉 경추(Cl-C7), 상부 흉추(D1-D4), 중부 흉추(D5-D8), 하부 흉추(D9-D12), 상부 요추(L1, 2), 하부 요추(L3-5) 및 천골로 나누어 총 105개 구역을 서로 비교하였다. 총 105개 구역 중 46개 구역에서 bone scan이나 MRI에서 양성으로 나왔는데 bone scan에서는 30개 구역(65.2%), MRI에서는 44개 구역(95.7%)에서 양성으로 나와 MRI 민감도가 bone scan 보다 높았다. 비교한 105개 구역 중 87개 구역(82.9%)에서 서로 일치하는 결과를 보인 반면 18개 구역(17.1%)에서 두 검사 결과가 서로 일치하지 않았는데 2개 구역에서는 bone scan에서 양성이나 MRI 검사에는 정상인 경우이고 16개 구역에서는 MRI 검사 결과 양성치나 bone scan에서 음성인 경우였다. 일치하지 않는 구역은 경추 구역이 가장 많았으며 진단별로 보면 위암의 경우에 가장 많았다. 한편 bone scan에서 12명의 환자에서 척추 이외의 다른 골격계에 전이 소견을 보였으며 2명의 환자 3개 구역이 양성으로 나왔으나 이 부위가 MRI 검사에 포함되지 않아 비교에서 제외되었다. 악성 종양의 척추전이를 진단하는데 MRI가 bone scan보다 민감하였지만 bone scan은 전골격계에 대하여 손쉽게 전이 여부를 평가할 수 있으므로 일차적 선별 검사로 매우 유용하다. 그리고 bone scan의 결과와 임상 소견이 일치하지 않을 때 MRI를 선택적으로 시행하면 진단의 정확성을 더욱 높일 수 있다.

• 대한방사선기술학회지:방사선기술과학
• /
• 제17권1호
• /
• pp.77-86
• /
• 1994

The bone scan reflects the metabolic reaction of bone to a disease process, whether neoplastic, traumatic or inflammatory. In normal bone tissue, the labeled diphosphate complexes accumulate in the perivascular fluid next to the marrow cavity at the interface between uncalcified and calcified bone matrix. HMDP has the most rapid plasma clearance among the commonly used diphosphonate followed by MDP and then HEDP. I have studied about bone scan time by use of $^{99m}Tc-MDP$, and got 336 images from 112 patients. The result obtained as follow; 1. Accumulation rate of $^{99m}Tc-MDP$ is higher than other age groups in below 30-year old group. 2. Accumulation rate, in 10year old group, is 75.85% on 120min. but other groups are most high on 180 min. 3. The density differants between bone and soft tissue increased with time. 4. Image contrast is good in younger group than old.

• 대한핵의학회지
• /
• 제38권1호
• /
• pp.109-110
• /
• 2004

Purpose: Tc-99m MDP bone scan was performed to evaluate a generalized bone pain in a 24-year-old male chronic myelogenous leukemia patient who received bone marrow transplantation at 7 months ago. The patient had received large amounts of blood transfusion for managing symptoms related to anemia. Bone scan revealed substantial splenic tracer uptake. Magnetic resonance image and laboratory evidence of hemochromatosis suggests that the presence of large quantities of iron in the spleen of this patient may have been responsible for the splenic uptake of the bone scanning agent. The authors report a case of splenic hemochromatosis incidentally found on Tc-99m MDP bone scan.

• 대한핵의학회지
• /
• 제36권2호
• /
• pp.143-145
• /
• 2002

A 49-year-old male patient with a carcinoma of the right pyriform sinus had a whole-body bone scan and gamma camera based F-18 FDG-PET for staging. Tc-99m MDP bone scan depicted diffuse increased uptake in the left femur due to chronic osteomyelitis but no skeletal metastasis. F-18-FDG-PET revealed increased focal bone uptake and uptake in the draining sinus due to chronic osteomyelitis in addition to visualization of the right pyriform sinus carcinoma and right neck nodal uptake. Fluorine-18 fluorodeoxyglucose-positron emission tomography is significantly more accurate than the bone scan in pinpointing chronic osteomyelitis focus and draining soft tissue infection.

• 한국임상수의학회지
• /
• 제19권1호
• /
• pp.103-106
• /
• 2002

Specific diagnosis of orthopedic disease can be diffcult in canine practice. Failure to detect the clinical signs of a disorder during physical examination of dogs with acute or chronic lameness is the most common reason for failure to make specific diagnosis. A 6-month-old, female doberman with history of swelling and non-weight-bearing lameness in the left forelimb was referred to Beterinary Teaching Hospital of Chungbuk National University. Physical examination, plain radiography, and conventional three-phase radionuclide bone scan were performed in the patient. Based on the physical exam and radiography, this case was diagnosed as elbow strain and subluxation. Conventional three-phase bone scan detected soft tissue inflammation and osteochondral lesions of elbow joint, and revealed good agreement with clinical findings. Therefore, conventional three-phase bone scan was able to provide the precise information about inflammation of soft tissue and osteochondral lesions of joint.

• 대한핵의학회지
• /
• 제30권1호
• /
• pp.1-14
• /
• 1996

Since the publication of the first bone scintiscans in 1962 three decades have elapsed. The bone scan has made great strides during this period, becoming one of the most commonly used nuclear imaging tests. In spite of the progress, however, the specificity of bone scan has remained relatively low. As the result it is a common practice to seek additional information from radiograph, CT scan and MR image, which is euphemistically termed as "image fusion or co-location." The basic reason is the inapplicability of the classical piecemeal analysis to interpreting planar and SPECT bone scans. Such analysis has its base on the observation of elemental features of morphology, which include the size, shape, contour, location, topography and internal architecture. The physiochemical profile may well also be included. Understandably, however, the miniatured images of the planar bone scan cannot provide these features in acceptable detail and the same holds true even with SPECT Images which are but sliced views of the reconstructed planar scans. Fortunately pinhole scanning has the capacity to portray both the morphological and chemical profiles of bone and joint diseases in greater detail through true magnification. The magnitude of pinhole scan resolution is practically comparable to that of radiography as far as gross anatomy is concerned. Thus, we feel strongly that pinhole scanning is a potential breakthrough of the long-lamented low specificity of bone scan. This presentation will discuss the fun-damentals, advantages and disadvantages and the most recent advances of pinhole scanning. It high-lights the actual clinical applications of pinhole scanning in relation to the diagnosis of infective and inflammatory diseases of bone and joint.