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微粒骨髓和松质骨移植修复牙槽突裂的条件和可行性。在这项研究中，对手术后1个月获得的CT图像显示明显骨吸收的不成功病例进行了评价。骨移植物的活性通过骨造影和MRI记录。在术后3个月获得的肺动脉造影和MRI上，在手术肺泡中没有急性炎症的证据。放射性造影显示裂区摄取减少，裂旁肺泡摄取增加。术后14个月，裂隙区的摄取减少逐渐变宽、变清晰。另一方面，术后14个月，裂隙邻近牙槽骨的高摄取仍部分存在.部分病例术后3个月行MRI T1加权成像，植骨部分呈类似脂肪组织的高信号。术后14个月MRI显示该区域延伸至邻近牙槽骨.从这些发现中，我们认为，骨造影术可能是有用的，以评估术后缺血性坏死的牙槽嵴裂，MRI可能是有用的，在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.