EVALUATION OF THE INCORPORATION OF BONE-GRAFTS USED IN MAXILLOFACIAL SURGERY WITH [F-18] FLUORIDE-ION AND DYNAMIC POSITRON EMISSION TOMOGRAPHY
EVALUATION OF THE INCORPORATION OF BONE-GRAFTS USED IN MAXILLOFACIAL SURGERY WITH [F-18] FLUORIDE-ION AND DYNAMIC POSITRON EMISSION TOMOGRAPHY
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DOI：
10.1007/bf00800595
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发表时间：
1995-10-01
期刊：
影响因子：
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通讯作者：
HUNDESHAGEN, H
中科院分区：
文献类型：
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作者：
BERDING, G;BURCHERT, W;HUNDESHAGEN, H
本研究通过[F-18]氟离子和正电子发射断层扫描（PET）研究了颌面外科手术中骨移植物的结合情况。它考虑了接受下颌骨重建的带蒂移植物或牙槽嵴增高的覆盖移植物的患者。在静脉注射[F-18-]氟化物后1小时内获得动态PET图像和动脉化静脉血样。采用三房室模型，应用多元线性最小二乘拟合，测定骨血流量（K-1）和氟内流（K-mlf）。此外，使用Patlak图分析来计算氟化物流入量（K-pat）。以颈椎体为参照区，K ~（-1）= 0.1162 ± 0.0396 ml/min/ml，K ~（-1）= 0.0508 ± 0.0193，K ~（-1）= 0.0385 ± 0.0102 ml/min/ml，与文献报道的动物和人的生理值基本一致。术后早期，在用于重建的移植物和受体骨之间的骨接合区域观察到与椎体相比流量和流入量显著增加（K-1 = 0.2181，K-mlf = 0.1000和K-pat = 0.0666 ml/min/ml）和在覆盖移植物中（K-1 = 0.2842，K-mlf = 0.1637和K-pat = 0.0827 ml/min/ml）。同时，蒂移植物显示出流量的显著增加，但内流没有增加（K-1 = 0.2042，K-mlf = 0.0774和K-pat = 0.0529 ml/min/ml）。此外，K-pat在带蒂移植物中显著低于在覆盖移植物中。在随访研究中，椎弓根移植物和骨接合区域的血流明显减少。此外，后者也显示出K-mlf的显著降低。结论：[F-18-] PET显示高嵌体移植物和骨接合区域的血流量和成骨细胞活性增加，表明术后早期移植物和邻近宿主骨中的骨修复。对于骨接合区域，两个参数的降低对应于简单的愈合。尽管椎弓根移植物的血流增加，但流入量没有增加，这很可能表明尽管血管通畅，但这些移植物中仍发生了一些坏死。可以得出结论，[F-18-] PET提供了对移植物掺入生物学的进一步了解。
This study investigates the incorporation of bone grafts used in maxillofacial surgery by means of [F-18]fluoride ion and positron emission tomography (PET). It considers patients who received pedicle grafts for mandibular reconstruction or onlay grafts for alveolar ridge augmentation. Dynamic PET images and arterialized venous blood samples were obtained within a 1-h period after i.v. injection of [F-18-]fluoride. Assuming a three-compartment model and applying multilinear least squares fitting, bone blood flow (K-1) and fluoride influx (K-mlf) were determined. Additionally Patlak plot analysis was used to calculate fluoride influx (K-pat). In cervical vertebral bodies as the reference region, mean values for flow of K-1 = 0.1162+/-0.0396 ml/min/ml and influx of K-mlf = 0.0508+/-0.0193 and K-pat = 0.0385+/-0.0102 ml/min/ml were found. Essentially these figures are comparable with physiological values in animal and man reported in the literature. Early after surgery a significant increase in flow and influx compared to vertebral bodies was observed in the regions of osteosyntheses between grafts used for reconstruction and recipient bone (K-1 = 0.2181, K-mlf = 0.1000 and K-pat = 0.0666 ml/min/ml) and in onlay grafts (K-1 = 0.2842, K-mlf = 0.1637 and K-pat = 0.0827 ml/min/ml). At the same time pedicle grafts showed a significant increase in flow but not in influx (K-1 = 0.2042, K-mlf = 0.0774 and K-pat = 0.0529 ml/min/ml). Furthermore K-pat was significantly lower in pedicle grafts than in onlay grafts. In follow-up studies a significant decrease in flow occurred in pedicle grafts and the regions of osteosyntheses. Moreover the latter showed a significant decrease in K-mlf as well. It is con eluded that [F-18-] PET depicted increased blood flow and osteoblastic activity in onlay grafts and regions of osteosyntheses, indicating bone repair in the graft and adjacent host bone early after surgery. For the regions of osteosyntheses the decrease in both parameters corresponded to uncomplicated healing. The lack of increased influx, although flow was increased in pedicle grafts, most Likely indicates that some necrosis occurred in these grafts despite patency of anastomoses. It may be concluded that [F-18-] PET provides further insight into the biology of graft incorporation.