Cinegammography and 3-D emission tomoscintigraphy for evaluation of revascularized mandibular bone grafts: a preliminary report.
The following reports a study conducted to investigate a scintigraphic monitoring procedure for bone free flap in mandibular reconstruction. This procedure is based on the one hand, on vascular and bone cinegammography, and on the other hand, on vascular and bone 3-D tomoscintigraphy. We used a prospective cohort study design. All patients who underwent free flap mandibular reconstruction from April 1993 to April 1998 in the Salpêtrière University Hospital, France (20 cases) have been evaluated in relation to this scintigraphic procedure. Vascular and bone scintigraphy were performed within the second week after surgery during 2 consecutive days. All images were read by one author (J.- Y. B.), who did not know the skin status of the flap. The results were compared with the viability of revascularized bone grafts as evaluated by the skin status and Greenberg classification based on bone radiographs three months after reconstruction. Vascular cinegammography seems to be closely related to anastomosis patency. Bone cinegammography gives appreciable information on bone viability. 3-D vascular tomoscintigraphy remains difficult to interpret. 3-D bone tomoscintigraphy gives precise information on the viability of the different segments of the bone flap. These results suggest that vascular and bone 3-D tomoscintigraphy coupled with cinegammography have an excellent prognostic value. In the event of partial failure it can give information on the location of the impaired patency and on the osseous fragment which has lost any viability.
Meningaud
J P
JP
Division of Stomatology and Maxillofacial Surgery, Pitié-Salpêtrière University Hospital, Paris, France. meningaud@wanadoo.fr
Basset
J Y
JY
Divaris
M
M
Bertrand
J C
JC
D000293:Adolescent; D000328:Adult; D000368:Aged; D016025:Bone Transplantation; D002933:Cineradiography; D005260:Female; D005720:Gamma Rays; D006801:Humans; D008297:Male; D008334:Mandible / Q000098:blood supply* / Q000000981:diagnostic imaging* / Q000601:surgery; D008875:Middle Aged; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D019651:Plastic Surgery Procedures; D013670:Sodium Pertechnetate Tc 99m; D013524:Surgical Flaps; D013669:Technetium Tc 99m Medronate / Q000031:analogs & derivatives; D015899:Tomography, Emission-Computed, Single-Photon / Q000295:instrumentation / Q000379:methods
D019275:Radiopharmaceuticals; C024226:technetium Tc 99m hydroxymethylene diphosphonate; D013670:Sodium Pertechnetate Tc 99m; D013669:Technetium Tc 99m Medronate