Abstract |
Avascular necrosis(AVN) of bone can be resulted from
various causes that distrub vascular supply to bone
tissue, includinrg steroid therapy after renal
transplantation. In this study, we determine the
prevalence of the avascular necrosis of bone after
renal transplantation and compare the role of the bone
scan, SPECT and MRI. In 301 patients with transplanted
kidney, the prevalence of avascular necrosis was
determined clinically. Site of bone necrosis was
evaluated by clinical symptom, bone scan, SPECT and
MRI. Bone scan was done in all patients with AVN. Bone
SPECT and MRI were done in six cases; and MRI was done
in two cases. The prevalence of AVN was 3.3% (10/301),
and the site of AVN was 16 femoral heads in 10 patients
(bilateral: 60%) and bilateral calcaneal tuberosity in
one patient. Bone scan showed typical AVN (cold area
with surrounding hot uptake) in 13 lesions, only hot
uptake in three lesions (including two calcaneal
tuberosities), decreased uptake in one lesion, and
normal in one lesion. Decreased uptake and normal
lesion showed an equivacal cold area without
surrounding hot uptake on SPECT. A symptomatic patient
with positive bone SPECT showed normal finding on MRI.
The prevalence of AVN of bone after renal
transplantation was 3.3%, and whole body bone scan
showed multiple bone involvement. Two symptomatic hip
joints without definite lesion on whole body bone scan
or MRI showed cold defect on SPECT. Threfore, we
conclude that bone SPECT should be perfomed in a
symptomatic patient with negative bone scan or MRI in
case with high risk of AVN after renal transplantation. |