Contemporary Possibilities of Scintigraphy of the Skeleton in the Diagnosis of Spinal Fractures in Children, Based on Correlation with MRI
D. Chroustová 1; E. Matoušková 2; H. Štěňhová; Lang . 0 1; T. Michaljanič 2
Klinika nukleární medicíny FN Královské Vinohrady, Praha, přednosta MUDr. O. Lang Oddělení dětské chirurgie FN Královské Vinohrady, Praha, 2 primář MUDr. P. Kryl Radiodiagnostická klinika FN Královské Vinohrady, Praha, 3 přednosta doc. MUDr. J. Šprindrich
Čes-slov Pediat 2002; (9): 487-492.
The assessment of spinal fractures in children is not always easy. Radiograph does not give the clear answer whether there is a spine fracture. Three-phase bone Scintigraphy detects the spine injury, but does not distinguish between fracture and contusion of the spine. In order to differentiate the fracture from contusion authors compared findings of three-phase bone Scintigraphy with MRI (Magnetic Resonance Imaging). Three-phase bone Scintigraphy was performed in 47 children with suspicion of spinal fracture using gammacamera HELIX (Elscint) and 5PECT (5ingle Photon Emission Computed Tomography). MRI was performed with F5ET2, 5ET 1 a 5TIR images of the spine on the same day. The rado of radioaktivity between the pathological and the nearest sound vertebra (sagittal sections of 5PECT) makes it possible to distinguish fracture or contusion. Thus, the values of the rado _< 1.2, 1.2 - 1.3 and z 1.3 were considered to be contusions, unclear findings and fracture, respectively.94 fractures and 49 contusions were described using MRI, 69 fractures and 14 contusions were described using Scintigraphy, unclear findings were described in 11 vertebrae. Identical findings (positive and negative) using Scintigraphy and MRI were recorded in 20 children (42 %). Findings agreed in 30 children (85 %) with the diagnosis of fracture, there were identical findings of slightly findings different. On the basis of identical positive and negative cases of spinal trauma in 44 children (92 %) and spinal fracture in 39 children (83 %) authors can conclude, that Scintigraphy is useful in the diagnosis of spinal fracture. According to authors' experience MRI is a more sensitive method with more accurate evaluation of the extent of the trauma compared to Scintigraphy. The specificity of MRI in differentiation between the fracture and contusion is not always unequivocal. It is necessary to obtain more experience with these problems using both methods.
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