Publication: Diabetik ayak ülserlerinde kombine kemik/Ga-67 ve kemik/Tc-99m HMPAO lökosit sintigrafilerinin karşılaştırılması
Abstract
Bu çalışmada, diabetik ayak ülserlerinde osteomyelitin tanısı ve takibinde kemik/Ga-67 ve kemik/Tc-99m HMPAO lökosit sintigrafilerinin değeri karşılaştırıldı. Diabetik 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, özgürlük 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 daha iyi gösterdiği saptandı. Sonuç olarak, diyabetik ayak ülserlerinde osteomyelit tanısında ve takibinde kemik/işaretli lökosit sintigrafisi, kemik/Ga-67 sintigrafisinden daha değerli bulunmuştur.
In this study, the value of combined bone/Ga-67 and bone/Tc-99m HMPAO labeled leukocyte scintigraphies 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 scintigraphies. The study was repeated 4-6 weeks after antibiotic treatment 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, speficity 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.
In this study, the value of combined bone/Ga-67 and bone/Tc-99m HMPAO labeled leukocyte scintigraphies 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 scintigraphies. The study was repeated 4-6 weeks after antibiotic treatment 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, speficity 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.