반신마비성 반사성교감신경 이영양증후군 환자의 골스캔상 견관절 섭취 (Shoulder Uptake in the Bone Scintigraphy in Patients with Hemiplegic Reflex Sympathetic Dystrophy Syndrome) |
Author |
이종진,정준기,이동수,홍준범1,한태륜1,이명철, |
Jong Jin Lee, M. D. , June-Key Chung, M. D. , Dong Soo Lee, M. D. , Joon Beom Hong, M.D.1, Tai Ryoon Han, M.D.1, Myung Chul Lee, M.D. |
Affiliation |
서울대학교 의과대학 핵의학교실, 재활의학과교실1 Departments of Nuclear Medicine, Rehabilitation Medicine1, Seoul National University College of Medicine, Seoul,Korea |
Abstract |
Purpose: Increased uptake of wrist and hand joints in three phase bone scintigraphy (TPBS) have been used in the
detection of reflex sympathetic dystrophy syndrome (RSDS). TPBS frequently shows increased shoulder uptake in the
hemiplegic RSDS patients. We investigated the significance of the shoulder uptake in the detection of these patients.
Materials and Methods: Twenty three patients who had hemiplegia due to brain stroke and diagnosed as RSD were
enrolled in this study (M:F=16:7, R:L=11:12). The mean age was 63±10 yrs. Ten normal volunteer (mean age: 60±5,
M:F=1:9) data was used as control group. TPBS was performed 59±32 days after stoke (acute stage). We obtained the
count ratios of bilateral hands by drawing a region of interest (ROI) in three phase images and compared to the
count ratios of shoulders in the delayed image. Hand ROI included an ipsilateral wrist. Sensitivity of detecting the
affected limb was defined using the right/left count ratio of normal control. Results: Sensitivities using count ratios of
hand blood flow, blood pool and delayed image were 45%, 76% and 78%, respectively. Sensitivity of shoulder count
ratio was 74%. Log of right/left counts of hand delayed image and that of shoulder delayed image were
correlated well with statistical significance (Spearman’s R=0.824, p<0.001). Conclusion: Shoulder uptake showed
good correlation with hand uptake in the delayed image of TPBS. Shoulder uptake maybe helpful in the diagnosis
of reflex sympathetic dystrophy syndrome in patients with hemiplegia. (Korean J Nucl Med 38(4):288-293, 2004) |
Keyword |
Key Words: Reflex sympathetic dystrophy, hemiplegia, three phase bone scintigraphy |
Full text Article |
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