반사성교감신경 이영양증후군 환자의 삼상 골 스캔 시 Half Body 혈액 풀 영상의 적용

Usefulness of Blood Pool Half Body in Three Phase Bone Scan in Patients with R/O Reflex Symphathetic Dystrophy Syndrome

Purpose: Three phase bone scan was considered sensitive in Patients with Reflex Symphathetic Dystrophy Syndrome (RSDS). Generally, three phase bone scan in the RSDS patients shows increased uptake of one side extremity joint. But three phase bone scan has been performed with flow, blood pool and delayed scan. We performed blood pool half body scan in order to investigate its usefulness. Materials and Methods: From October 2007 to September 2009, three phase bone scan (flow, blood pool, half body blood pool, delayed) was performed after injection of 750 MBq of ⁹⁹ᵐTc-DPD in diagnosed patients with RSDS (M:F=8:7, R:L=9:6). For quantitative analysis, we obtained the count ratios of bilateral hands by drawing a region of interest (ROI) in the three phase images and compared with the count ratios of shoulders in half body blood pool and delayed images. Results: In flow images, right/left ratios were 1.09±0.53. In blood pool images, right/left ratios were 1.13±0.47 (hand), 1.08±0.26 (shoulder). In delayed images, right/left ratios were 1.24±0.75 (hand), 1.11±0.31 (shoulder). As a result, Log of right/left counts of the others and that of shoulder blood pool image were correlated well with statistical significance (Spearman’s R, p<0.005 SPSS for windows ver.12.0). Conclusion: Half body blood pool scan may be helpful in the diagnosis of patients with RSDS. Moreover, Half body blood pool scan reduced false negative and false positive rates. In order to improve agreement on interpretation of RSDS, Blood pool half body scan should be established as common criteria.