Evaluation of the viability of the transplanted bone glaft for alveolar cleft using blood flow measurement and SPECT

本研究的目的是评估自体颗粒骨髓和松质骨移植治疗牙槽裂的状况和生存能力。本研究对术后1个月CT图像显示有明显骨吸收的失败病例进行评价。用核素骨显像和磁共振成像方法记录移植骨的存活情况。术后3个月行核素扫描和核磁共振检查，未见术后肺泡有急性炎症。核素扫描显示裂隙区域摄取减少，邻近牙槽骨摄取增加。至术后14个月，裂隙区摄取减少的范围逐渐扩大，逐渐变得清晰。另一方面，裂隙邻近牙槽骨的摄取增加在术后14个月仍有部分保留。部分病例术后3个月的T1加权MRI表现为部分高信号，与脂肪组织相似。术后14个月MRI显示，该区域延伸至邻近牙槽骨。根据这些发现，我们认为核素扫描可能有助于评估术后牙槽裂中的缺血性坏死，而MRI可能有助于评估骨桥的脂肪骨髓成熟程度。

The purpose of this study was to assess the condition and viability of the autogenous particulate marrow and cancellous bone grafted for alveolar cleft. In this investigation, unsuccessful cases that showed marked bone resorption on CT images obtained 1 month after the operation were evaluated. The viability of bone grafts was documented by means of bone scintigraphy and MRI.1. On the scintigrams and MRI obtained 3 months after the operation, there was no evidence of acute inflammation in the operated alveolus. The scintigrams revealed the decreased uptake at the cleft region and the increased uptake at the adjacent alveolus of the cleft. The decreased uptake of the cleft area gradually became wider and clearer until 14 months after the operation. On the other hand, the increased uptake at the adjacent alveolus of the cleft still partially remained at 14 months after the operation.2. On T1-weighted MRI obtained 3 months after the operation of some cases, the grafted bone showed partially hyper intensity similar to the fatty tissues. This area extended to the adjacent alveolus on the MRI obtained 14 months after the operation.3. From these findings we suggest that scintigraphy may be useful to evaluate postoperative avascular necrosis in the alveolar cleft, and that MRI may be useful in assessing the fatty marrow maturation of the bone bridge.