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骨裂的状况和生存能力。在本研究中，对术后1个月CT图像显示明显骨吸收的不成功病例进行评估。通过骨显像和核磁共振成像记录骨移植的生存能力。术后3个月的星状图和MRI未见手术肺泡急性炎症。闪烁图显示裂隙区摄取减少，裂隙邻近肺泡摄取增加。术后14个月，裂隙区摄取减少逐渐变宽、清晰。另一方面，在术后14个月，唇裂邻近肺泡的摄取增加仍部分保持。部分病例术后3个月t1加权MRI显示移植物骨部分呈类似脂肪组织的高强度。术后14个月的MRI显示，该区域延伸至邻近的肺泡。根据这些发现，我们认为闪烁成像可能有助于评估肺泡裂术后的缺血性坏死，MRI可能有助于评估骨桥的脂肪骨髓成熟。

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.