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  • 2017년 11월호
    [Nucl Med Commun.] The clinical significance of technetium-99m methylene diphosphonate bone scintigraphy findings in patients with rhabdomyolysis.

    순천향대학교 천안병원 / 이정원, 이상미*

  • 출처
    Nucl Med Commun
  • 등재일
    2017 Oct
  • 저널이슈번호
    38(10):820-825.
  • 내용

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    Abstract

    OBJECTIVE:

    This study evaluated the relationship between bone scintigraphy finding and clinical factors and assessed the prognostic value of bone scintigraphy finding in patients with rhabdomyolysis.


    PATIENTS AND METHODS:

    We retrospectively enrolled 143 patients with rhabdomyolysis who had undergone bone scintigraphy. Bone scintigraphy was classified into three groups: no or equivocal soft tissue uptake, a localized uptake, and a diffuse uptake. The relationship of bone scintigraphy findings with clinical factors was evaluated. Multiple logistic regression analysis was performed to identify the risk factors for acute renal failure (ARF) and renal replacement therapy (RRT).


    RESULTS:

    Of 143 patients, 52 (36.4%) experienced ARF and 12 (8.4%) required RRT. Among cases caused by exercise, 83.7% showed localized soft tissue uptake. Diffuse soft tissue uptake was only shown among the patients with rhabdomyolysis caused by drug and toxin. Patients with localized or diffuse soft tissue uptake had higher levels of serum creatine kinase, myoglobin, aspartate aminotransferase, alanine aminotransferase, and lactate dehydrogenase compared with patients with no or equivocal uptake (P<0.05). Multiple logistic regression analysis showed that age, female sex, and serum phosphate level were associated with a risk for ARF and only serum creatinine level was associated with a risk for RRT (P<0.05). Bone scintigraphy findings failed to show significance for predicting ARF and RRT (P>0.05).


    CONCLUSION:

    Soft tissue uptake on bone scintigraphy in patients with rhabdomyolysis was related to etiologies and showed limited value for predicting ARF and RRT.​

     

    Author information

    Lee JW1, Lee EY, Hong SY, Yoo ID, Lee SM.

    aDepartment of Nuclear Medicine bInstitue for Integrative Medicine, Catholic Kwandong University College of Medicine, International St Mary's Hospital, Incheon cDepartment of Internal Medicine dDepartment of Nuclear Medicine, Soonchunhyang University, Cheonan Hospital, Cheonan, Korea.

    ​ 

  • 연구소개
    임상 핵의학자로 가장 많이 보는 검사중 하나인 골스캔에서 연조직 섭취소견을 보일 수 있는 횡문근 융해증의 임상적 의미에 관하여 분석한 논문입니다. 횡문근 융해증은 다양한 원인에 의하여 발생할 수 있으나 본연구에서는 크게 외상 및 약물에 의한 원인으로 분류하였으며 원인에 따라 다른 영상소견으로 관찰됨을 알 수 있었습니다. 그 외 횡문근융해증의 예후인자들로써 골스캔의 의미를 분석하였습니다. 농약등 중독연구가 활발한 본원에서 다양한 원인으로 인한 횡문근융해증의 골스캔 검사를 경험할 수 있어 임상 판독중에 원인에 따라 어떤 경향성이 있다는 생각이 들어 시작된 연구였습니다. 횡문근융해증의 특이한 원인으로 인한 골스캔의 증례 보고들은 많이 이뤄지고 있으나 그 방향에 관한 분석 연구는 거의 없으며, 기존에 있던 임상개념들을 핵의학 분야와 함께 생각할 수 있는 유용한 연구입니다.
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