Využití SPECT vyšetření v diagnostice poškození mediálních menisků

Title in English The usage of SPECT in the diagnostics of medial meniscal tears


Year of publication 2012
Type Article in Periodical
Magazine / Source Ortopedie
MU Faculty or unit

Faculty of Medicine

Field Traumatology and orthopaedic surgery
Keywords SPECT; medial meniscus tears; lesion
Description The purpose of this study was to analyse the possibilities of the application of scintigraphic examination (SPECT) in the diagnostics of medial meniscus tears, in those cases where it is not possible to use the Magnetic Resonance Imaging (MRI) examination, which can be contraindicated in a relatively high percentage of patients. Method and material: 32 patients with clinical symptoms of medial meniscus tears underwent the SPECT examination, through which the distribution and activity of the radiopharmaceutical (Tc99m) in the medial compartment of the examined knee was evaluated. The study proceeded in the period from 2006 to 2010. 15 men and 17 women of the average age of 47 years (age range from 22 to 70 yrs) took part in the study. The examination was followed by arthroscopy, in order to either verify or disconfirm the supposed lesion. The arthroscopy was performed at 2.8 months after the SPECT examination on average (ranging from 1 week to 11 months). On the basis of the obtained results, the sensitivity, specificity, positively predicted value, negatively predicted value, and veracity were calculated. Results: The SPECT examination supported the diagnosis of a medial meniscus lesion in 22 patients out of the total number of 32, which was thereafter confirmed arthroscopically. The findings from both examinations were negative in 6 patients. In 1 patient, the SPECT examination was positive, but the arthroscopy did not confirm the lesion. The SPECT examination was negative in 3 cases, but arthroscopy revealed a medial meniscus lesion. The sensitivity of the SPECT examination for the detection of medial meniscus lesions was 88 %, the specificity was 86 %, the positively predicted value (PV+) 96 %, the negatively predicted value (PV-) 67 %, and the veracity 87.5 %. Discussion: The values of sensitivity, specificity, PPV, NPV and veracity are comparable to the results published in the literature concerned with the SPECT application in medial meniscus lesion diagnostics. Conclusion: The study has confirmed that the SPECT method can be a useful examination method in medial meniscus lesion diagnostics, where the MRI examination is contraindicated or unavailable. The positive result is crucial for an orthopaedist, as it proves the medial meniscus damage almost certainly.

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