Publication: Diabetik ayak ülserinde kombine kemik/Ga-67 ve kemik/Tc-99m HMPAO lökosit sintigrafilerinin karşılaştırılması
Abstract
Bu çalışmada, diyabetik ayak ülserlerinde osteomyelitin tanısı ve takibinde kemik/Ga-67 ve kemik/Tc-99m HMPAO lökosit sintigrafilerinin değeri karşılaştırıldı. Diyabetik ayak ülseri olan 17 hastada, üç fazlı kemik, Tc-99m HMPAO lökosit ve Ga-67 sintigrafileri uygulandı. 9 hastada, çalışma antibiyotik tedavisinden 4-6 hafta sonra tekrarlandı. 24 ayak ülserinden 13'ünde radyoloji, doku kültürü veya doku biyopsisi ve takip ile osteomyelit tanısı kondu. Duyarlılık, özgüllük ve doğruluk değerleri sırası ile kemik sintigrafisi için % 100, % 36, % 70, kemik/Ga-67 sintigrafisi için % 84, % 45, % 66, kemik/lökosit sintigrafisi için % 92, % 73, % 83 olarak bulundu. Tedavinin etkinliğini, lökosit sintigrafisinin Ga-67'e göre daha iyi gösterdiği saptandı. Sonuç olarak, diyabetik ayak ülserlerinde osteomyelit tanısında ve takibinde kombine kemik/işaretli lökosit sintigrafisi, kemik/Ga-67 sintigrafisinden daha değerli bulunmuştur.
İn this study, the value of combined bone/Ga-67 and bone/Tc-99m HMPAO labeled leukocyte scintigraphy in the diagnosis and follow-up of osteomyelitis in diabetic foot ulcers was compared. Seventeen patients with diabetic foot ulcers were underwent three-phase bone, Tc-99m HMPAO labeled leukocyte and Ga-67 scintigraphy. The study was repeated 4-6 weeks after antibiotic treatment in 9 patients.For the 24 ulceration sites, 13 cases of osteomyelitis were diagnosed on the basis of radiology, tissue culture or biopsy and follow-up. The sensitivity, specificity and accuracy were found to be 100 %, 36 % and 70 % for bone scan, 84 %,45 % and 66 % for combined bone/Ga-67 scan, and 92 %, 73 %, and 83 % for combined bone/leukocyte scan, respectively. It was demonstrated that the efficacy of treatment was more accurately shown with leukocyte scan compared with Ga-67. In conclusion, in the diagnosis and follow-up of osteomyelitis in the diabetic foot ulcers, combined bone/leukocyte scan is more valuable than combined bone/Ga-67 scan.
İn this study, the value of combined bone/Ga-67 and bone/Tc-99m HMPAO labeled leukocyte scintigraphy in the diagnosis and follow-up of osteomyelitis in diabetic foot ulcers was compared. Seventeen patients with diabetic foot ulcers were underwent three-phase bone, Tc-99m HMPAO labeled leukocyte and Ga-67 scintigraphy. The study was repeated 4-6 weeks after antibiotic treatment in 9 patients.For the 24 ulceration sites, 13 cases of osteomyelitis were diagnosed on the basis of radiology, tissue culture or biopsy and follow-up. The sensitivity, specificity and accuracy were found to be 100 %, 36 % and 70 % for bone scan, 84 %,45 % and 66 % for combined bone/Ga-67 scan, and 92 %, 73 %, and 83 % for combined bone/leukocyte scan, respectively. It was demonstrated that the efficacy of treatment was more accurately shown with leukocyte scan compared with Ga-67. In conclusion, in the diagnosis and follow-up of osteomyelitis in the diabetic foot ulcers, combined bone/leukocyte scan is more valuable than combined bone/Ga-67 scan.