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ORIGINAL ARTICLES  PEDIATRICS II 

The Quarterly Journal of Nuclear Medicine 1998 June;42(2):133-47

Copyright © 2000 EDIZIONI MINERVA MEDICA

lingua: Inglese

Bone scintigraphy in non-neoplastic diseases in children

Roßmuller B., Hahn K., Fischer S.

From the Department of Nuclear Medicine Ludwig-Maximilliams-University, Munich (Germany)


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Since ­the intro­duc­tion of 99mTc ­labeled poly­phos­phates ­bone scin­tig­ra­phy ­has ­become a wide­ly accept­ed meth­od ­for ­the eval­u­a­tion of ­non-neo­plas­tic ­bone dis­eas­es in chil­dren. High qual­ity imag­es ­require ­the ­child’s immo­bil­isa­tion ­and a cor­rect posi­tion­ing as ­well as an opti­mized tech­ni­cal equip­ment. Two or ­three ­phase scin­tig­ra­phy is ­the rou­tine­ly pro­ce­dure ­but addi­tion­al tech­niques ­like pin­hole imag­es or ­SPECT ­can be ­very help­ful ­for spe­cial indi­ca­tions ­and local­isa­tions. Due to ­the ­age ­and ­sex depen­dent dif­fer­enc­es of ­bone metab­olism in ­the devel­op­ing skele­ton ­the inter­pre­ta­tion of ­the ­bone ­scan in chil­dren is ­more dif­fi­cult ­than in ­adults ­and ­requires ­more expe­ri­ence. Infections, trau­ma ­and asep­tic necro­sis ­are ­the ­most impor­tant ­non-neo­plas­tic dis­eas­es requir­ing ­bone scin­tig­ra­phy. Bone ­scan ­has a ­high sen­si­tiv­ity in ­the ear­ly detec­tion of path­o­log­i­cal ­bone metab­olism indi­cat­ing ­bone dis­ease; oth­er inves­ti­ga­tions, ­which ­are describ­ing mor­pho­log­i­cal chang­es ­like X-­ray ­are ­less sen­si­tive espe­cial­ly at ­the begin­ning of ­the dis­ease. Negative ­bone ­scan ­rools ­out sig­nif­i­cant ­bone dis­or­ders ­with a ­high cer­tain­ty. Follow-up stud­ies ­can ­give addi­tion­al infor­ma­tions ­about ­the ­response to ther­a­peu­ti­cal ­regimes ­and ­about ­the prog­no­sis. To ­improve ­the spe­cif­icity of a ­bone ­scan a com­bined inter­pre­ta­tion of scin­tig­ra­phy ­and X-­ray is rec­om­mend­ed.

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