[Bone angioscintigraphy].

Abstract

Classical bone scintigraphy can be completed by a dynamic study of the blood supply of a previously defined anatomical region. Our protocol consists of the recording of early images in the histogram mode, centred on the selected pathological region and on the symmetrical region which acts as a control. One film is taken every 3 seconds for 3 minutes following an intravenous injection of 20 mci of Tc99m MDP into a cubital fossa vein. More limited symmetrical zones of interest are visualised on the image obtained by summation of all of the information obtained during the second minute following the arterial passage of the radioactive bolus. The curve reflecting the variation in activity for each zone of interest over these three minutes can therefore be obtained. The first part of the curve, until the first slope change, corresponds to the arterial phase (blood flow), the second part, which includes a brief venous phase, corresponds to the vasculo-tissue phase (blood pool). The value of these bone image, which allow a very detailed analysis of the topography and intensity of the uptake, is above all diagnostic, while the early, vascular images and the resulting curves are essentially of pathophysiological interest. Bone angioscintigraphy is a triple examination and one of its best applications is in reflex sympathetic dystrophy. It is able to distinguish very objectively between "hot" and "cold" forms and it can indicate the most appropriate treatment for each case and follow the effects of treatment. The other indications for bone angioscintigraphy also include Paget's disease, especially the monitoring of treatment, osteomyelitis, sarcomas and osteonecrosis.