1Scintigraphy of the bones of the skeleton: preparation, conduct and price of the examination
- 1.1What is osteoscintigraphy?
- 1.2Side effects
- 1.3Where osteoscintigraphy is done
- 1.4Radioisotope diagnosis of bones
- 1.5Preparation for scintigraphy
- 1.6How the bone scan is done
2How is the scintigraphy of the bones of the skeleton: preparation, interpretation of the results, where to make and the price
- 2.1Indications and contraindications for use
- 2.2Preparation for scintigraphy
- 2.3How is the scintigraphy of the bones of the skeleton carried out?
- 2.4Evaluation and interpretation of results
- 2.5Where is a radioisotope test done?
3Features of scintigraphy of the bones of the skeleton: preparation for examination and the result of diagnosis
- 3.1general information
- 3.3Indication for the study
- 3.5How to prepare: advice for patients
- 3.6How is diagnostics performed?
- 3.7Preparations for skeletal scintigraphy
- 3.8After the procedure
- 3.9Possible complications
- 3.10Explanation of results
4Scintigraphy of bones of the skeleton: how it is conducted and what you need to know
- 4.1What is scintigraphy?
- 4.2When a procedure is assigned
- 4.3Contraindications for scanning
- 4.4Preparing for the procedure
- 4.5Conducting research
- 4.6Main advantages
- 4.7Features of the study
5What is a scintigraphy of bones skeleton: tzzyva, where it is made and how much does it cost?
- 5.1Principle of research
- 5.2Indications for research
- 5.3Contra-indications and limitations
- 5.4The course of the study
- 5.5Cost of the procedure
- 5.6Patient Reviews
Scintigraphy of the bones of the skeleton: preparation, conduct and price of the examination
The procedure for examining the bones of the skeleton and tissues based on radioisotope radiations will allow us to assess the state of the organs for the purpose of appropriate treatment.
This method of functional visualization is carried out in a special gamma camera. Doctors say - osteoscintigraphy is superior in performance to standard radiography.
What is osteoscintigraphy?
This innovative radiation diagnosis, able to determine the current state of organs and the integrity of the structure of body tissues.
The procedure will help to identify malignant formations in the cells, as well as changes in the bones at the earliest stages (before the appearance of external signs).
The use of scintigraphy of the bones of the skeleton will reveal all the problems associated with the occurrence of all kinds of ailments of tissues, which contributes to the appointment of timely and adequate therapy.
To obtain the correct picture of the study, radionuclides are introduced into the body - special markers (contrast agents), the radiation of which is displayed on the screen of a gamma camera.
Thanks to this, all damaged and damaged tissues become visible. The indicators appear on the monitor with hot foci. These places are the centers of defeat.
Radioactive isotopes are practically harmless to the body, which makes the procedure safe and extremely popular.
Scintigraphy of the bones of the skeleton is prescribed for:
- diagnosis of problems causing bone pain;
- detection of microscopic fractures of the bones of the skeleton;
- identification of joint diseases (arthritis, arthrosis);
- determination of the presence of abnormal inflammatory, infectious processes in bone tissues;
- diagnostics of cancer and other oncological diseases (presence of metastases, neoplasms);
- planned surveys during the treatment of malignant tumors and their effects on the body;
- with suspicions of pathological osteomyelitis.
Despite the practical absence of contraindications for radionuclide testing, some side effects may still occur. For example, scintigraphy of bones of the skeleton is not recommended for pregnant and lactating women.
If the examination should be done during lactation, then the natural diet of the baby should be resumed no earlier than 2-3 days after the procedure.
Doctors do not prescribe scintigraphy to patients who, a few days prior to her, underwent radiography with barium, since the results may be inaccurate.
People studied on a gamma machine should refrain from communicating with children and women in the situation (minimum day).
At home, you should thoroughly wash your hair and take a shower, wash clothes that were on the patient during irradiation.
Do not take medical materials with you from a scan of the bones of the skeleton - cotton wool, syringes, bandages and other preparations are disposed of in a special hospital way.
The price to pay for the innovative gamma diagnostics of the bones of the skeleton ranges from 2 to 15 thousand. rubles.
Everything depends on the medical facility itself and on what area of the skeleton needs to be examined. The average cost of osteoscintigraphy (total bone-joint apparatus) is 5-6 thousand. rubles.
For carrying out the procedure on separate organs, you will have to spend various amounts, for example, research on:
- kidneys - from 3500 r .;
- thyroid gland - from 2500 r .;
- myocardium - from 7500 r .;
- lungs - from 4000 r.
Where osteoscintigraphy is done
Scintigraphy of the bones of the skeleton is performed in specially equipped private medical centers, state clinics, on the basis of research institutes, since it is necessary to work with radioactively dangerous elements. After researching and processing information on the computer, all data is transferred to the doctor for the purpose of this or that treatment. Specialized medical institutions offer basic services:
- Static radionuclide diagnostics of the bones of the skeleton - a small number of examinations and obtained images for the detection of pathologies.
- Dynamic radionuclide diagnostics of bones of the skeleton - a series of images (continuously or through time intervals appointed by the doctor) to identify diseases associated with skeletal damage and joints.
Radioisotope diagnosis of bones
Radionuclide study of the bones of the skeleton is divided into two periods - preparation and, directly, diagnostics. The main advantage is that the procedure will help to identify cancerous foci and metastasis immediately throughout the skeleton.
To the obvious pluses should be attributed and the small dose of radiation received by the patient. Therefore, if you need to identify the dynamics of therapy, the study can be conducted monthly.
The dose of radiation obtained after scintigraphy is a fraction tens of times smaller than in radiography.
Preparation for scintigraphy
Special instructions or strict limitations before the radioisotope examination of the bones of the skeleton doctors do not indicate.
On the day of the procedure, a light breakfast is allowed, and during the introduction of a radiological substance, a large amount of water is assigned (at least four glasses).
Immediately before the test, it is necessary to completely empty the bladder. Do not use any medications.
How the bone scan is done
Radioisotopic examination of the bones of the skeleton is carried out in several stages:
- A special radio indicator is introduced into the vein (use strontium or technetium), which spreads through the body, is introduced into the bone tissue for two to three hours. While waiting, you must use at least four glasses of clean water, take a recumbent position, limit movement.
- Next, a snapshot of the bones of the skeleton is made on a special apparatus consisting of a gamma camera and a procedural table. Scanning takes approximately one hour, and this is the time the patient must hold motionless. During scintigraphy the apparatus finds the damaged parts of the skeleton, due to the localization of radioactive indicators (hot spots) in them.
- After the procedure, you must definitely drink at least a liter of water (to speed up the removal of radioactive substances from the body). Although their concentration is negligible, it is dangerous for young children and women in the situation. The image of bones obtained by scintigraphy is sent to the attending physician to determine the degree of the disease and the purpose of appropriate therapy.
A source: http://sovets.net/6142-stsintigrafiya-kostei-skeleta.html
How is the scintigraphy of the bones of the skeleton: preparation, interpretation of the results, where to make and the price
When bone tissue is subjected to tumor and other pathological lesions, a thorough diagnosis is required to determine the disease. In this case, specialists often resort to such a diagnostic method as scintigraphy.
Usually it is used to determine bone metastasis, to identify arthritis and other pathological processes.
Scintigraphy of skeletal bones is a diagnostic imaging technique used in medical practice to determine the degree metastasis of malignant processes, to assess the extent of the pathological process in bone tissues and the musculoskeletal system rights.
This is a radionuclide diagnostic technique involving the introduction of a special radio drug into the body, and further monitoring of its distribution along the bone skeleton. Osteoscintigraphy allows to reveal early stages of development of bone pathologies, structural and functional changes in the skeleton.
Scintigraphic research has a lot of advantages, one of which is the ability to detect pathological processes in at the initial stages of their development, approximately 4-6 months before the possibility of determining them through the traditional radiography.
- Such a technique, unlike other diagnostic techniques, allows to identify pathological the process is still at a stage when structural changes are not yet available, but the functionality of the affected organ is already is broken.
- The procedure is usually well tolerated and does not cause complications, although in rare cases, allergic reactions are noted in patients.
- The radiation emitted by the administered substance is very low and does not depend on the number of images or the duration of the diagnostic study.
The only drawback of scintigraphy experts call the lack of information to establish an accurate diagnosis.
In this study, some types of cancerous lesions of bones are not visible, such anomalous and normal bone growths do not distinguish between such diagnoses.
Therefore, to determine the etiology of the pathological process, additional studies such as biopsy, computer and magnetic resonance imaging or radiography are carried out.
Indications and contraindications for use
Such a study is prescribed only if there are specific indications:
- Suspicion of metastasis in bone tissue;
- Lesions of bone structures (myeloma, etc.);
- Therapy of bone damage like usual, stressful or compression fractures;
- Identification of inflammatory pathologies in articular and bone structures (arthropathies of dismetabolic type, arthritis or osteomyelitis);
- To identify the causes of vertebral pain, to diagnose various types of articular inflammation, as a differential diagnosis of benign tumors or malignant pathologies of the secondary character;
- To identify pathologies of incomprehensible origin associated with muscular, articular or osseous structures;
- To determine the viability or functionality of bone grafts;
- In order to evaluate the effectiveness and effectiveness of radionuclide treatment, radiotherapy or chemotherapy, etc .;
- To detect infectious and inflammatory processes or the inferiority of joint prostheses.
The procedure is harmless to the body, but with its appointment, several available contraindications such as breastfeeding and pregnancy, allergic reaction or intolerance radiopreparation.
If there was an urgent need for a diagnosis, then breastfeeding should be stopped for 3 days.
Contraindicated carrying out osteoscintigraphy to patients who received radiography with barium in the next 4 days.
In addition, scintigraphy can not be performed by a patient with a severe health condition. After irradiation with a gamma machine, contact with children or pregnant women due to radiated radiation must be avoided within 24 hours.
After the procedure, it is necessary to wash the clothes in which the patient was during the procedure, and also to wash thoroughly.
Preparation for scintigraphy
Special preparation for osteoscintigraphy of the bones of the skeleton is not required. The patient should inform the expert in advance about the available allergy to medicines.
The patient must necessarily sign a consent for the diagnosis. The study itself is a long and routine diagnostic procedure.
Patients are advised to use more fluid before and after the study. This is necessary for better spread of contrast and for its rapid removal after diagnosis.
The duration of waiting after the introduction of contrast depends on the type of substance - some spread throughout the body per hour, while others take up to 5 hours to do this.
The procedure of scintigraphy is meaningless in patients taking drugs containing vitamin D and calcium.
These substances contribute to reducing the absorption of radioactive contrast. In addition, before the procedure is to exclude the use of estrogen and antitumor drugs.
How is the scintigraphy of the bones of the skeleton carried out?
The study must be carried out by removing ornaments, in loose clothing or a special gown.
- The patient is given an intravenous injection of a radioactive substance (radioactive strontium or an isotope of technetium). The injected drug spreads through organic structures, concentrating in bone tissues.
- Scanning is carried out after 2-3 hours after the introduction of contrast.
- If the purpose of the study is to diagnose osteomyelitis or infectious-inflammatory lesions, then several pictures can be taken immediately after the introduction of contrast.
- In other cases, in the waiting process, doctors recommend drinking more liquid to avoid delaying the radioactive substance in the inorganic structures. But before the scan, you must necessarily empty the bladder.
- The patient is placed on a special table, where he needs to lie still, because even minor activity negatively affects the quality and readability of the pictures.
- The procedure is absolutely painless, although prolonged stay in an immobilized state can cause some inconvenience.
- The duration of the scan is about an hour, after which the patient returns to normal life.
- Within 2 days after diagnosis, it is necessary to drink more liquid to accelerate the removal of radioactive contrast.
Evaluation and interpretation of results
The patient receives the decoding of scintigraphic images, recommendations and extracts immediately after diagnosis, the next day or several days later.
The results are processed in accordance with various parameters:
- Depending on the number of foci of metastasis;
- In accordance with impulse indicators over healthy and affected areas;
- By the ratio of impulse activity over bone tissues to background indices.
During the research, the specialist receives various categories of images: synchronized, tomographic, dynamic and static.
Each of the images is able to show the structure of the organs and the degree of their damage, which provides extensive and thorough study of the functionality of the bone structures being studied.
Most often metastasis is revealed in the costal, cranial, pelvic and vertebral bones.
As a result of the diagnosis, positive sites may appear, so-called.
hot spots, which are characterized by a congestion of radioactive contrast, indicating bone damage.
There may be negative areas or cold spots - these are places where there is no contrast isotope, so there are no bone lesions in these areas.
The procedure of scintigraphy is characterized by the reliability of the results in 85-95% of cases. But even such a highly informative study can give false-negative results. Therefore, such a diagnosis requires additional studies to clarify the diagnosis.
Adequate interpretation of the results has a leading significance in terms of the correctness, quality and effectiveness of the subsequent therapeutic process. This is especially important in cases of suspicion of vertebral cancer.
Where is a radioisotope test done?
The procedure for scintigraphy of the bones of the skeleton is available in the state medical centers and private specialized clinics of the capital in the order of preliminary consultation and recording.
Similar services render in clinics like:
- GKB number 1 them. Pirogova;
- OAO "Medicine
- FBTC them. Burnazyan;
- LRC of the Ministry of Health of the Russian Federation;
- Research Institute of JV. Sklifosovsky and others.
The cost of the procedure for scintigraphic examination of the bones of the skeleton depends on the status of the clinic and its location:
- In Moscow medical institutions the price of research will be about 2600-13080 rubles;
- In Krasnodar, such a procedure will cost in 2400-8600 rubles;
- Ekaterinburg clinics are ready to conduct osteoscintigraphy for 2500-8000 rubles.
Although the price for conducting this research is quite high, its significance exceeds any costs.
Osteoscintigraphy is much more effective than radiological diagnostics and allows detecting bone pathologies on initial stages of their formation, which contributes to the timely treatment and prolongation of patients' lives in the case of oncology.
about the radioisotope method of studying the bones of the skeleton:
A source: http://gidmed.com/onkologiya/diagnostika-onk/stsintigrafiya-kostej-skeleta.html
Features of scintigraphy of the bones of the skeleton: preparation for examination and the result of diagnosis
With diseases of the spine, joints, suspected development of malignant tumoral process, to control the treatment of oncology, doctors prescribe scintigraphy of the bones of the skeleton. To assess the state of hard tissues, small doses of radioactive drugs are used.
With a low radiation load, the modern diagnostic method provides detailed information on the state of dense tissues throughout the body. The study has few limitations, the interpretation of the results allows doctors to timely adjust the treatment regimen, clarify the condition of the problem organs. P>
During the examination, physicians perform functional visualization by introducing radioactive components to obtain a detailed image of all parts of the skeleton. To assess the degree of tissue damage, physicians determine the strength of radiation of injected drugs.
A complicated device - gamma-tomograph - was developed for the procedure. After the drip or injection of the patient's radioactive material, the patient is placed in the tomograph for reading by means of a gamma camera accumulating and distributing a special preparation in the bone system.
The procedure is multi-stage, the duration of the study is several hours. Despite some discomfort associated with the duration of the examination, the technique is often used by specialists of modern clinics to identify lesions in the early stages of oncological diseases.
Types of scintigraphy of the skeleton:
- statistical.The doctor orders a limited number of images to clarify the morphological characteristics of a particular area. Comparison of different zones allows us to identify a malignant tumor process;
- dynamic.The doctor requires a series of pictures (continuous or with a certain period of time). It is important for a specialist to see the dynamics of changes in bone tissue. The frame rate is selected proportionally, according to the speed of the pathological processes that need to be monitored.
Scintigraphy is a method of early diagnosis. The behavior of the radiography shows metastases in the bones, when more than half of the dense tissue has lost its functionality.
Unlike other methods, scintigraphy indicates a pathological process when cells are in the normal state, but the functions are already violated.
Early detection of negative changes allows to prevent the onset of oncological pathologies due to the timely initiation of specific therapy.
Despite the lower image clarity than with tomography (MRI and CT), a highly informative technique has positive aspects:
- simple preparation;
- low radiation dose;
- To monitor the results of treatment, scintigraphy can be performed even monthly;
- examination of all parts of the skeleton;
- precise definition of a single or multiple lesions, the spread of metastases;
- effective control of the results of chemotherapy or the condition of the patient after resection of the tumor or problem organ;
- the possibility of determining the risk of relapse after treatment of oncopathologies. Even in the absence of negative manifestations during the six months after irradiation and chemotherapy, active capture of radiopharmaceuticals on the surface of bones suggests a tendency to a recurrent course pathology.
Indication for the study
Scintigraphy with the use of radioisotopes is prescribed not only for diagnosis and for monitoring the treatment of cancer. The modern technique helps to identify many pathological processes in the skeleton departments in the early stages.
Indications for the procedure:
- diagnosis of complex fractures of the bones of the skeleton, if the X-ray did not show a clear picture;
- elucidation of the causes of unexplained soreness in the joints and spine;
- clarification of the risk of recurrence of the tumor process;
- diagnostic measures for suspected development of osteomyelitis;
- detection of severe pathology - cancer of the spine and bones;
- suspected osteonecrosis;
- clarification of the presence or absence of metastases in various organs. In most cases, without scintigraphy, it is difficult to determine how far the metastasis process has gone. Only a complete examination of the bones of the skeleton using radioisotopes shows how the cancer has spread along dense structures;
- there are signs indicating the development of Paget's disease with a structure disorder, deformation of bone tissue;
- preparation for an operation to remove the mammary glands during a malignant tumor process;
- Suspicion of the development of diseases, including infectious ones, adversely affecting the metabolic processes in bone tissue: tuberculosis, osteoporosis;
- the doctor assumes presence at the patient of thinning of a bone tissue (fibrous dysplasia).
The study using radioisotope drugs is not performed during pregnancy. During the procedure, there is a potential radiation hazard to the fetus.
You can not perform scintigraphy of the skeleton during lactation. If the baby is on natural feeding, then you need to warn the doctor about the process.
Sometimes, radiation diagnosis can not do without serious evidence.
In this case, scintigraphy during lactation is carried out, but after the study a woman should not breast-feed another 5 days after the procedure to leave the remnants of radioactive preparations.
How to prepare: advice for patients
Before the procedure, doctors are advised to drink more liquid. This moment is important for obtaining high-quality images and prompt removal of radioactive contrast medium from the body. The patient should temporarily remove the piercing, remove the metal jewelry.
Special training is not needed, but in order to reduce the risk of errors, several types of drugs must be abandoned:
- Beta-blockers for cores (substances accumulate in tissues, can reduce the clarity of images);
- iodine preparations - one month before the scintigraphy. You can not even lubricate scratches with an alcohol solution of iodine;
- compositions containing bromine. This component often contains sedatives and cough medicines.
How is diagnostics performed?
Stages of research:
- the first part of the procedure - the introduction of contrast medication with a minimum level of radiation exposure. Next - the waiting period for three hours: the substance must get into all parts of the skeleton, enter into the cellular metabolism;
- when the radiopreparation has accumulated in the tissues, the patient occupies the position of "sitting" or "lying". An indispensable condition for conducting qualitative diagnostics is complete immobility during the whole time of scanning the organism;
- During the procedure the patient is on a special moving table. A large crystal of the gamma camera records radiation emanating from the entire surface of the trunk;
- the patient should not talk, but he hears a doctor, who necessarily sends commands from the next cabinet;
- the examination is quite long, while the scintillation crystal can not be moved, which is not very convenient for children and seriously ill patients. To reduce nervousness, these categories receive sedatives (sedatives).
On a note!On the procedure it is desirable to wear old clothes, with which it is not a pity to part. Even careful washing does not guarantee 100% removal of radionuclides. For this reason, it is better to throw things away (put in a special container in a medical facility).
Preparations for skeletal scintigraphy
To reduce risks, doctors use ultrashort-living and short-lived radionuclides.
Components of specific pharmaceuticals operate from a few minutes to 5-6 hours.
For scintigraphy of the skeleton, physicians use compounds based on fluorine, iodine, oxygen, carbon, helium. Technetium 99 and indium 113 are obtained by the generator method.
The route of administration is intra-arterial or intravenous. The greatest accumulation of radioisotopes occurs in the foci of the skeleton, in which oncological and degenerative - dystrophic processes occur, as well as in the areas of metastasis.
The main names of preparations for scintigraphy of the skeleton:
- Zoledronic acid.
After the procedure
The patient should listen to the doctor's recommendations to avoid unnecessary exposure:
- at the end of the study, you should immediately take off the clothes in which the procedure was going on, leave bandages, handkerchiefs, cotton wool in the office, so as not to take with them objects that have been exposed to radiation. To collect radioactive waste in the clinic, special containers have been prepared;
- it is useful to drink more green tea, compote of dried fruits, mineral water without gas, not very sweet mors, broth of wild rose for active removal of radionuclides with urine and sweat;
- after the study you need to take a shower, be sure to wash your hair.
Negative reactions depend on the general condition of the patient, individual characteristics of the organism:
- allergic manifestations: skin itch, rash-like rash;
- itching and sensation of heat at the site of the introduction of the radiopharmaceutical;
- jumps in blood pressure, difficulty breathing, deterioration of the general condition in severe forms of pathology.
Explanation of results
Doctors evaluate the data from different sides:
- check the ratio of impulses over healthy areas and the lesion;
- reveal the ratio of background activity to the number of pulses over the skeleton;
- They reveal metastatic foci, specify the degree of cancer spread in remote organs.
After the examination, the doctor examines the pictures, if necessary, collects a consultation to find out the opinions of other specialists. According to the results of scintigraphy of bone tissue, the doctor prescribes treatment or adjusts the previously selected methods of therapy.
A modern SPECT / CT scanner with a gamma camera is needed for the study. The equipment is provided by high-level inter-institutions and oncological dispensaries.
Scintigraphy of the skeleton is an expensive procedure: the estimated price of one study is up to four thousand rubles.
Despite the high cost of the procedure with the use of radionuclides, doctors are strongly recommended to undergo a tomography examination with a gamma camera for early diagnosis of severe pathologies.
Do not wait until the metastases spread throughout the body, if there is a method that allows you to start treatment before the destruction of tissues.
Timely carrying out of scintigraphy of bones of a skeleton allows to recognize a recurring character of oncological disease before occurrence of a painful syndrome in tissues. Based on the pictures, the doctor prescribes treatment to prevent the pathology from turning into a severe form.
Learn more about the benefits and features of scintigraphy of the bones of the skeleton from the following clip:
A source: http://vse-o-spine.com/bolezni/diagnostika/stsintigrafija-kostej-skeleta.html
Scintigraphy of bones of the skeleton: how it is conducted and what you need to know
Osteoscintigraphy is used to diagnose bone pathologies relatively recently.
Therefore, patients who receive referral to the procedure are often concerned about the question: "Scintigraphy of the bones of the skeleton - what is it?".
This method is a scan of bone tissue to identify infectious, traumatic, oncological and other diseases.
What is scintigraphy?
The method of examining the skeleton using scintigraphy is referred to the newest technological section of nuclear medicine. This type of visualization is a method of radiation diagnosis. The procedure looks like this:
- In fact, radioactive isotopes are used for diagnostics in this case, which are also called isotopes-markers or indicators. A small amount of radionuclides is introduced into the patient's body.
- Then, using a special camera called a gamma camera, they take pictures of the bones of the skeleton.
- Some areas of bone tissue absorb a small dose of radionuclide markers (or not at all absorb them), that in the pictures it is visible, how small blackouts, which in medicine are called "cold" sites. In these cases, there are reports of the presence of certain types of malignant tumors or of impaired blood circulation.
- Most of all, the marker is absorbed by the bones of the skeleton, where tissues are restored or actively grow. In the pictures such areas look bright, they are called "hot". This may indicate the presence of arthritis, micro-fractures, infections and some types of bone cancer.
Scintigraphy of the bones of the skeleton is divided into dynamic, when several photographs are taken continuously or at regular intervals, as well as static (a small number of pictures of the affected body).
When a procedure is assigned
Most often scanning of the skeleton completely or its individual parts is assigned in order to:
- Identify metastases or bone formation in the early stages. Visualization accurately determines the primary bone cancer, for example, chondrosarcoma, as well as secondary tumors that result from tumors of other organs.
- Examination of bone fractures, especially the hips, if it is not possible to make a clear picture using standard radiography.
- To establish the etiology of pain in the bone system, if it was not possible to find the reason for carrying out other diagnostic procedures. Most often this diagnostic method is used to establish the location of anomalies in some complex bone structures, for example, in the feet or the spinal column. In this case, scintigraphy is usually combined with an MRI or CT scan.
- To detect damage to bone tissue that are caused by impaired internal organs or infections (a rare Paget's disease).
The study is also used to identify arthritis, arthrosis and pathological osteomyelitis. In the presence of a malignant tumor of the bone system, such procedures can be planned, repeated.
Contraindications for scanning
Since radionuclides are used in this procedure (the radioactive indicator is most often the isotopes of technetium or strontium, which is introduced through the catheter intravenously into the patient's blood), there are certain contraindications for the diagnosis of this type:
- Pregnancy. Theoretically, the concentration of marker radionuclides is not too great to cause harm to the child. However, there is practically no research in this area, therefore, during the entire period of pregnancy such scanning of the skeleton is carried out with vital necessity for the future mother.
- Lactation period. Isotopes contained in markers almost completely penetrate into breast milk, so after a procedure for at least three days, it is necessary to express it to preserve lactation. Expressed milk must be poured, because it is dangerous for the child.
- Allergic reactions. If the patient has a tendency to manifest allergies, it is necessary to tell the attending physician about this before carrying out the study. Radionuclides can cause both an ordinary skin rash, and more serious consequences, for example, anaphylactic shock.
In addition, if a patient has recently been diagnosed with barium (often used in X-rays it may distort the quality of the pictures, so it is also necessary to inform the diagnostics.
Preparing for the procedure
All preparation for the survey is as follows:
- If the scan is carried out in a planned manner, a month before the patient starts it is recommended to stop using iodine, including externally or in the form of preparations for internal administration. Also, you should stop taking drugs that contain calcium and vitamin D, antitumor agents and estrogen.
- Before and after the examination, it is recommended to take a lot of fluids. After the introduction of the indicator, the patient should drink at least one liter of pure water so that the contrast spreads better throughout the body.
- It is necessary to remove ornaments, clothes should be free.
Before the study begins, a radioactive substance is introduced intravenously, which spreads through all organic structures, but is concentrated only in bone tissues.
Initially, the patient is instructed on the diagnosis - what is it like to behave. After 2-3 hours after the injection of the contrast agent, the scan begins:
- if the diagnosis of infectious inflammatory diseases or osteomyelitis is required, several pictures are taken immediately after the introduction of the marker;
- in other cases, the patient drinks water, before the procedure empties the bladder;
- then it is placed on a special table, during the procedure it is necessary to lie as motionless as possible, so as not to disturb the readability of the pictures;
- pain or other unpleasant sensations during the scan does not occur;
- The duration of the procedure is about 1 hour;
- after the procedure must be a plentiful drink.
According to the results of the study, a specialist can obtain several different images - tomographic, static, synchronized or dynamic.
Scintigraphy, despite the presence of contraindications, has several undeniable advantages:
- Low cost of research in comparison with other modern methods;
- a small dose of radiation, which allows you to scan monthly, which is optimal for monitoring the dynamics of therapy (especially bone cancer of the bone tissue);
- the ability to detect pathological changes in the bones at the earliest stages, which is key in the treatment of cancer;
- lack of preparation - there is no need to follow a diet, refuse to take medication (except for iodine, calcium and barium);
- the ability to scan at once the entire human skeleton and to reveal metastasis wherever tumors are localized;
- simple procedure without pain and discomfort;
- a small dose of radiation in comparison with radiography.
The disadvantages of this type of diagnosis include: the need to lie still during the scan, the restriction on the patient's age (not held for children under 14 years old).
Features of the study
Scanning the bones of the skeleton is not able to distinguish between pathological and physiological entities in bone tissue.
That's why most often the pictures obtained during the diagnosis are considered in conjunction with the patient's complaints, the examination of the attending physician and the results of MRI, CT, biopsy, blood tests.
Some types of malignant neoplasms can not be identified at the time of this type of diagnosis.
The normal results of scintigraphy is the uniform distribution of the indicator in the bone tissue. There should be no accumulation of isotopes in certain areas. Light or dark areas of bone tissue in the picture indicate a pathological change in the bones.
Despite the use of isotopic substances, the method is quite safe, since the share of irradiation is low, and the patient practically does not receive any negative impact. After performing the manipulation it is shown to take a warm shower with soap and clothes to wash.
All materials used during the procedure (napkins, cotton swabs) are disposed of in a special scheme, like radioactive waste.
The patient is recommended after the procedure to drink as much fluid and for one day does not contact with children or pregnant women.
Scanning the bones of the skeleton to date is the only informative way to identify pathologies, including cancer, that are localized in bone tissues.
At the same time the method is absolutely painless, safe, the radiation load is minimized, which makes it possible to carry out diagnostics quite often and to observe the development of the disease in dynamics.
For comparison: when performing X-ray, the dose of irradiation is more than 10 times higher than in the case of osteoscintigraphy.
A source: https://DiagnostLab.ru/kt/pozvonochnika/stsintigrafiya-kostej-skeleta.html
What is a scintigraphy of bones skeleton: tzzyva, where it is made and how much does it cost?
Scintigraphy of the bones of the skeleton is a modern method of diagnosis, which allows you to assess the degree of accumulation of radioactive material with bone tissue.
Scintigraphy of the bones of the skeleton is most common in cancer patients. This study allows to determine the presence or absence of tumors in the bone tissue, to note the occurrence of metastases at an early stage.
Information on neoplasms, as well as on the degree of accumulation of radiopharmarate with bone tissue allows you to choose the optimal method of treatment in each case, based on the individual characteristics of the patient and development disease.
Scintigraphy is also used during the treatment of cancer patients - the study allows assessing the dynamics of neoplasm development. Also scintigraphy of the bones of the skeleton is important for assessing the effectiveness of the treatment used.
Scintigraphy is also used to detect latent fractures, cracks, identify areas of bone necrosis and pathological foci in them.
Principle of research
For scintigraphy a special tomograph is used - it registers the gamma radiation of radioactive particles that are distributed in the human body.
There is a static and dynamic scintigraphy of the bones of the skeleton:
- Static research is used to assess the morphological structure of bone tissue.The accumulation of radioactive substances is recorded as cold and hot foci. This method is most often used to detect neoplasms.
- Dynamic scintigraphy allows you to take a series of shots at intervals.This kind of research allows not only to assess the foci of accumulation of radioactive material, but also to estimate the distribution in bone tissue.
For scintigraphy of bone tissue, labeled monophosphates and bisphosphates are most often used. These drugs have the greatest tropism to the bone structures that are only being formed.
Specific preparation for scintigraphy of the bones of the skeleton is not required. Doctors recommend a day before the procedure to drink a volume of fluid, which is 2-3 times the daily rate.
This will allow to obtain pictures of a higher quality, as well as to remove radioactive substances from the body, at the end of the procedure.
Discuss the conduct of scintigraphy of bones of the skeleton with a doctor is also necessary if in the scheme of treatment of the disease there are preparations containing barium or bismuth. These substances reduce the signal transmission from radionuclide particles to the gamma camera. For this reason, there is a risk of obtaining inaccurate results.
It is also worthwhile to discuss the possibility of using a scintigraphy of the bones of the skeleton if it is necessary to carry out radiography of the abdominal cavity organs. To assess the structure and patency of the intestine, a barium mixture is used.
If it is necessary to carry out both radiography and scintigraphy, it is necessary to notify the attending physician about this, and also to try to conduct the studies with an interval of 4-5 days.
Indications for research
Conduct scintigraphy for the study and detection in the bones of the skeleton of pathological processes and foci.
The main indications for this procedure are:
- The need to identify cracks and microcracks in the bones of the skeleton, the so-called "stress fractures."These fractures most often occur with high loads on one part of the body and the most vulnerable to them are the bones of the lower limbs - feet, legs, thighs. Although most of these fractures heal independently and do not require outside intervention, in some cases, the associated pain can cause significant discomfort and require surgery. To determine the site to be surgically intervened, scintigraphy is used;
- Infectious damage to bone tissue.The purpose of the study - diagnosis of osteomyelitis - a disease that affects the pelvis and spine, as well as long limbs, and the latter are affected only in children. The infection itself can be associated with both bone damage and inflammation of the surrounding tissues;
- Inflammation of the joints, or arthritis.The task of scintigraphy in this case is to determine the type of arthritis, of which there are more than 100 species and the search for all joints affected by it. The disease is very common and most often occurs with infection of the body with bacteria, weakness of the immune system, fractures and as a result of age-related weakening of the body;
- Diagnosis of neoplasms and detection of metastatic lesions of bone tissue.Scintigraphy can detect both benign and malignant tumors. This study also helps to identify metastatic foci in the bone tissue in the early stages. In oncology, scintigraphy of the bones of the skeleton is also used to assess the effectiveness of the effect of therapeutic measures on neoplasm. Another indication for the use of scintigraphy in oncology is the evaluation of the dynamics of tumor development.
- Diagnosis of Paget's disease.Paget's disease lies in the abnormal development of bone tissue - with her after fractures of the bone They heal much faster than normal, but the new tissue is thinner and weaker in comparison with previous. As a consequence, the probability of a repeated fracture increases significantly;
- Diagnosis of rickets.This disease causes increased flexibility of the bones of the skeleton and as a consequence - their curvature. Most often, rickets appear in children and is associated with a deficiency in the body of vitamin D, the main sources of which are sunlight, as well as fish, dairy and sour-milk products;
- Determination of the complexity of the fracture.Compared with X-ray, scintigraphy allows us to assess not only the severity of the fracture itself, but also to determine the presence of bone fragments in the soft tissues of the body;
- Detection of foci of necrosis.Necrosis of the bones arises from the violation of blood circulation. As a result, bone structures begin to deteriorate, which can lead to the appearance of pathological fractures and manifest as strong pain sensations.
Contra-indications and limitations
There are no direct contraindications to scintigraphy, but there are certain limitations:
- Pregnancy.The procedure provides for the creation of a high concentration of radionuclides in the body, which can fetus, therefore, scintigraphy in pregnant women should be carried out only when life-saving is needed women;
- Lactation.During the procedure, radionuclides will necessarily go into breast milk, which after that, the baby can not be fed. At least three days after the scintigraphy, breast milk should be expressed. If the patient turns out to transfer the baby to the food mix, then it must be prepared in advance and keep the necessary amount of milk for later feeding;
- Propensity to allergic reactions.Before the procedure, it is necessary to tell the doctor about all available allergic reactions and the tolerability of medications. Exposure to radionuclides can cause the patient to have an allergic reaction, and this can be either simple rashes on the skin or anaphylactic shock.
- Age of the patient.Children are categorically advised against scintigraphy. The accumulation of radiopharmaceutical in the children's body can be caused by an imperfect radionuclide removal system. An exception is oncological pathology.
The course of the study
The first stage of scintigraphy of the bones of the skeleton is the introduction of a radioactive preparation. Do it intravenously.
After the administration of the drug, it takes three hours before the results are recorded.
This will allow the drug to distribute evenly in the body and engage in the natural metabolism of cellular structures.
At the end of the necessary time, the patient is asked to take a sedentary or reclining position (based on the purpose of diagnosis of pathology). The radiologist goes to the next room, from where he can communicate with the patient.
During the whole procedure, a person should be stationary. It is forbidden even to speak. After switching on, the table on which the patient is located begins to move, enabling the gamma camera to register radiation from all parts of the body.
The time of scintigraphy of the bones of the skeleton takes from half an hour to an hour.
After the procedure, during the day, it is recommended to use a lot of liquid and visit the shower - this will help to remove the remnants of radionuclide substances from the body.
The obtained data of scintigraphy of the bones of the skeleton is interpreted by a radiologist together with an oncologist.
The information received may indicate:
- presence or absence of cracks and a fracture in the bones of the skeleton;
- the stage of formation of the callus;
- presence or absence of tumors;
- the occurrence of metastases in the cage tissue (scintigraphy is the only method of investigation that allows to detect metastatic damage at an early stage);
- the effectiveness of therapy;
- prevalence of necrotic process;
- occurrence of sequestration sites.
When performing scintigraphy, the doctor receives images, a human skeleton, in which the color of each bone is determined by the degree of accumulation of the radioactive element in it. The pathological state manifests itself in the form of a "hearth".
A cold center corresponds to a decrease in the accumulation of radioactive material, while a hot focus indicates that the accumulation of radioactive material in this zone is increased.
When carrying out a dynamic study, the doctor can also evaluate the sequence of radionuclide drug in the bone tissue, which allows to identify even the minimal foci of pathological tissue in the structure bones.
Cost of the procedure
Scintigraphy is one of the most popular methods of detecting lesions of bone tissues. So, in Moscow, scintigraphy of the skeleton will cost the patient in the amount of 2600 rubles. up to 13000 rubles.
The price policy depends on the clinic in which the procedure is performed, as well as on the contrast medium that is administered to the patient.
In St. Petersburg, prices are somewhat cheaper - the cost of scintigraphy ranges from 3000 to 8000 rubles. In Tomsk scintigraphy of the skeleton will cost the patient 4000 rubles, and in Tyumen - about 3000 rubles.
The average price for scintigraphy in Russia is 4000 rubles.
Patients who underwent scintigraphy of the bones of the skeleton leave various responses. They note both negative and positive features of this study.
The positive aspects of scintigraphy of the bones of the skeleton include:
- high efficiency of the procedure;
- absence of pain during scintigraphy and after it;
- no need for special preparation for the procedure.
However, at the same time, people who have undergone research point to some shortcomings:
- a small number of devices for scintigraphy in the regions;
- the need to record for research;
- high cost of the procedure;
- long time of procedure - up to 4 hours from the moment of the beginning;
- concerns about exposure to the body.
Also, many patients note that before the procedure there is a strong fear associated with obtaining the results of scintigraphy.
In most cases, scintigraphy is performed to identify neoplasms or metastatic lesions of bone tissue. Despite the high accuracy of the study, people are afraid to hear the conclusion of a specialist and learn about a possible unpleasant diagnosis.
A source: http://SpinaSpina.com/diagnostika/scintigrafiya-kostej-skeleta-chto-eto-takoe.html