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. 2014:2014:256256.
doi: 10.1155/2014/256256. Epub 2014 May 11.

Clinical value of 99Tcm-MDP SPECT bone scintigraphy in the diagnosis of unilateral condylar hyperplasia

Bing Wen  1 , Ying Shen  1 , Chang-Yin Wang  1
Affiliations

Clinical value of 99Tcm-MDP SPECT bone scintigraphy in the diagnosis of unilateral condylar hyperplasia

Bing Wen et al. ScientificWorldJournal. 2014.

Abstract

Purpose: To investigate the clinical value of (99)Tc(m)-MDP SPECT for the diagnosis of unilateral condylar hyperplasia (UCH).

Methods: One hundred forty-nine patients who underwent mandibular (99)Tc(m)-MDP SPECT between January 2009 and December 2012 were studied, including 105 cases that were clinically suspected of UCH and 44 comparable cases without UCH as a control group.

Results: Increased bone activity was observed in the affected condyles for all UCH patients. In the UCH group, the relative percentage uptake on the affected side was 59% (SD ± 4.3%), significantly higher than the 41% (SD ± 4.1%) uptake on the contralateral side (P<0.001). Similarly, the condyle/skull ratio was significantly higher for the affected side (1.66 ± 0.63) than for the contralateral side (1.34 ± 0.34, P < 0.01. No significant difference was found in the control group between the left and right condyles. Values for the sensitivity (95%), specificity (61%), positive (84.4%) and negative (84.6%) predictive values, and accuracy (84.5%) for (99)Tc(m)-MDP SPECT in the diagnosis of UCH were calculated. However, for the hyperplastic condyle, no correlation was observed between the thickness of each cartilage layer and the relative uptake in the SPECT image.

Conclusion: (99)Tc(m)-MDP SPECT is accurate for diagnosing UCH and can provide a reference for treatment options.

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Figures

Figure 1
Figure 1
TMJ SPECT images of a patient (male, 21-year old) with right-sided condylar hyperplasia. An abnormally high uptake of radioactivity in the right condyle was observed in the axial, sagittal, and coronal reconstructions relative to the left side.
Figure 2
Figure 2
Anterior planar image of the head of a patient (male, 17-year old) with right side condylar hyperplasia. The center of the mandible was biased towards the left, and the bone metabolism of the right condyle was found to be active.
Figure 3
Figure 3
The pathology image of a patient (male, 21-year old) with UCH (HE ×100). (A) Obvious thickened perichondrium; (B) wide proliferative zone, small and flat-shaped undifferentiated mesenchymal cells distributed sparsely; (C) thickened hypertrophic layer (calcified cartilage layer).
See this image and copyright information in PMC

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