High-resolution multi-detector SPET imaging of the paediatric spine.
We reviewed the planar and single photon emission tomographic (SPET) spine images of 69 paediatric patients aged 2-17 years referred for undiagnosed back pain. The SPET images were obtained using a triple-detector camera and ultra-high-resolution collimation. Abnormal images were rated as slightly positive (1+) or strongly positive (2+). The planar and SPET images were normal in 48 of 69 patients. Thirteen of the remaining 21 cases had negative planar imaging with positive SPET images (SPET was 2+ in 10 cases and 1+ in 3 cases). Four of the 21 cases were 1+ on planar imaging, but clearly positive (2+) on the SPET images. Three of the 21 cases had 2+ planar abnormalities, but SPET demonstrated additional uptake abnormalities. Lastly, a single case that was 2+ on the planar images was demonstrated to be artefactual by SPET. Thirty-seven sites were abnormal by SPET, including 17 pedicle/parts interarticularis (11 patients), 10 spinous process (8 patients), 8 vertebral endplate (2 patients) and 2 vertebral body (2 patients) abnormalities. Sites that were abnormal on SPET and normal on planar imaging included 10 of 17 (59%) in the pedicle/pars region, 9 of 10 (90%) in the spinous process, 1 of 2 (50%) in the vertebral body and 2 of 8 (25%) in the vertebral endplates. The improved resolution of ultra-high-resolution collimated multi-detector SPET permits visualization of a greater variety of abnormalities than was seen with earlier single-detector cameras, particularly those involving the spinous process.
Kriss
V M
VM
Department of Radiology, Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA.
Elgazzar
A H
AH
Gelfand
M J
MJ
Golsch
G J
GJ
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D006801:Humans; D017116:Low Back Pain / Q000000981:diagnostic imaging*; D013131:Spine / Q000000981:diagnostic imaging*; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D014057:Tomography, X-Ray Computed