Bone scintigraphy skeleton of what it is. Preparation for the examination is carried out, which shows decoding results, consequences. Addresses and prices in Moscow, St. Petersburg

For ascertaining painful changes in the bones of the skeleton is important to find out where are the areas in which metabolic processes are violated. Scintigraphy - a modern method to pinpoint the locations of such violations.

What is a bone scan

Bone scintigraphy of the skeleton - it is the study of an organism, with the help of which you can even see a slight change in the structure and function of bone tissue. It is particularly important to obtain information at an early stage of the disease, which simplifies treatment and improves the prognosis for the patient.

Visualization is achieved by recording radiation, the entered into the body of a special material from the group of radiopharmaceuticals. Radiopharmaceutical contains a radioactive isotope of technetium (label) and affinity (tropism) to the bone, then it accumulates there primarily in bones, forming a strong bond with the bone mineral base.

Especially brightly lit areas of increased osteosynthesis in which enhanced circulation and metabolism is accelerated. They are called hot zones.

Principle of operation unit

Bone scintigraphy of the skeleton - it is a radiological examination that uses the scintillation effect. He is the appearance of a very short light flashes when an atom absorbs a portion of the ionizing radiation.

RFP includes:

• Molecule vectors. This complex phosphorus compounds. They bind to the hydroxyapatite molecules that make up 50% of bone tissue and collagen fibers in the connective tissue.
• Radiolabelled. isotope of technetium is most often used with a mass number of 99. Disintegrating, technetium atom emits energy portion (gamma ray).

Radiation falls on a crystal scintillator. So called substances which give the atoms a flash of visible light or ultraviolet light after absorption of gamma quantum.

Detector gamma camera flash capture, amplify them in the photomultiplier. The computer adds this picture to a vast number of tiny flashes the screen and generates a picture label accumulation in various parts of the body.

Pros and cons of the procedure

The use of bone scintigraphy has the following advantages:

• Early diagnosis. Many tumors are accompanied by metastatic disease. For example, myeloma complicated by bone metastases almost always. Timely start of treatment can prolong the patient's life for up to 2-5 years.
• the sensitivity is very high. False-negative results (which means that the survey did not find the existing modified site) occur in less than 1% of cases.
• This procedure allows the physician to quickly correct information. It does not need time to prepare the patient and the results will be ready in the day of the test.
• Minimum cost. A small amount of RFP allows you to immediately see the centers, if any, to assess blood flow in them, the intensity osteoplasty (bone formation at the injury site), and other functional characteristics throughout body. We study the entire skeleton. This is especially valuable for determining metastasis, since they are often multiple, widespread.
• Timely relapse prognosis. If after treatment there is no outward signs of illness, and the level of accumulation of RFP is still high, the risk of recurrence is great. In this case, early diagnosis is particularly important.

For all its advantages, scintigraphy lacks contrast, pathological focus image is blurred edge. Other techniques used to further refine the diagnosis.

Side effects

Radiation RFP small. The radiation dose is ten times less than in the X-ray, and not a danger to the patient or to the people around him.

Gamma Camera does not radiate, it is intended to register quanta of electromagnetic energy, so the duration of the study and the number of the pictures does not affect the dose of radiation received body.

The half-life (the so-called time interval during which the amount of the substance is reduced by half) to technetium-99 very short, little more than 6 hours, and then after 2 days in the body does not remain even a trace amount of radioactive tags.

Possible consequences

Allergic reactions to radiopharmaceuticals are rare.

Less than 5% of patients may experience:

• feeling itchy skin;
• small and large areas of skin redness (urticaria);
• difficulty breathing.

Bone scintigraphy of the skeleton - it is a survey that almost no adverse effects on the body.

Units of the examinees complained:

• fatigue, a feeling of lethargy, drowsiness;
• dizziness;
• slight nausea.

Usually these unpleasant sensations due to the fact that the patient was to be examined hungry.

Developed radiopharmaceuticals short-lived isotopes (they are degraded and excreted within a few hours). In the case where it is assumed very quickly obtain the necessary information, you can use ultra-short-isotopes with half-lives of a few minutes.

A general rule for selecting the radiopharmaceutical is: The half-life period should be equal to the anticipated duration of the study, which reduces exposure of the body to the minimum necessary.

Compliance with this rule makes it possible without risking a patient's body to appoint repeated surveys an interval of a few weeks, if it is necessary to observe the dynamics of the process on a background therapy.

To the drug as quickly as possible eliminated from the body, and it recommended drink amplified thorough hygiene. Immediately after the procedure, the patient returns to normal life, no remedial action is required.

Indications and contraindications

Procedure is prescribed in the following cases:

• Soreness bones for no apparent reason. In these cases, the physician must exercise caution in relation to the formation of metastases (if there is a tumor in history).
• Diseases of the joints, as they are accompanied by an increased accumulation of the RFP, which facilitates diagnosis.
• Injuries of bones, especially if they fail to diagnose in the X-ray.
• Motility (labile) of the prosthesis, pathological changes in bone in prosthetics.
• Neoplastic processes (prostate cancer, lung cancer, breast, thyroid), accompanied by the formation of new lesions, remote from the primary.
• Observing the dynamics of the pathological process, evaluation of the effectiveness of treatment, the need for correction purposes.
• Before the operation, to determine the required volume of surgical aids.
• Purulent processes (osteomyelitis).
• The need for differential diagnosis of degenerative and neoplastic processes.

Contraindication to this procedure can be considered pregnancy, because at this time it is necessary to limit all kinds of radiation exposure as possible.

Introduction RFP may threaten the normal development of the fetus. About pregnancy the patient should inform your doctor and specialist performing scintigraphy prior to administration of radiopharmaceuticals, even if the pregnancy is only supposed to be.

LIMITATIONS This procedure is prescribed in the following cases:

• Breastfeeding is necessary to interrupt at 48 hours after drug administration, and milk expressed and discarded. 2 days radiopharmaceutical cleaved and excreted through kidney, then it is possible to resume normal feeding.
• The patient before the bone scan must tell your doctor and specialist performing the procedure of allergy or hypersensitivity to any substance, even if such reactions appear a long time ago.
• It is recommended not to handle the wound with iodine and not to use its drugs in the month before the scintigraphy.
• At the same term should refrain from bromine drugs (it contain, for example, drugs for cough and soothing preparations). This is necessary to avoid decreasing the information content of images.
• Blockers that accumulate in the body during long-term course of treatment of cardiovascular diseases, in the this time should be replaced by other drugs, or bone scan to move to a later term.
• Young children, preferably in place of scintigraphy appoint other survey methods.
• Men who take drugs to restore sexual function, it is necessary to suspend the treatment for 2 days prior to scintigraphy.
• You can not assign other X-ray and radiological procedures in conjunction with bone scintigraphy. The interval between them should be at least 48 hours.

In these cases, the attending physician may prescribe bone scan, if there are serious reasons for this.

Preparation for scintigraphy

Osteotsintigrafiya does not imply special preparation of the patient. This procedure does not restrict the person mode and diet. This applies to the period before and after the procedure. It is important to prepare the patient psychologically.

you must:

• to show him the importance of the survey,
• explain scintigraphy safety compared with other radio and radiological methods of examination;
• The advantages that gives this method.

It should bring the patient, appearing in the survey:

• his patient card;
• the results of previous surveys;
• report on the results of X-ray, tomography, magnetic resonance examinations, if they were carried out.

Data on the course of the disease will help you to process more informative.

Progress in the bone scan

Radiopharmaceutical comprising a technetium-99 is administered intravenously. Intra-arterial injection is rarely used. The preparation starts immediately absorbed by bone tissue.

The required amount of the radiopharmaceutical for the investigation accumulated for 2 hours.

• The patient to drink approximately one liter of liquid during this time. It helps the body to withdraw the RFP, which was not absorbed by the tissues and remain in the blood.
• Scanning is carried out 2-3 hours after drug administration.
• Before scanning, you need to visit the toilet.

  

• Clothing does not interfere with the procedure, but metal objects (necklaces, earrings, other jewelry, belts buckles, keys, money, and the like) can not be left to themselves, because they distort the results research.
• Scintigraphy may take from 10 min. 1 h.
• The specialist carrying out the examination, the patient gives instructions that must be followed to obtain the most accurate results.
• You may need to make a repeat or additional pictures.
• All the time, while continuing the procedure, the patient should not move. For many it is difficult to keep still for an hour, so to get clear images may require sedation, and for restless patients and children, even a short anesthesia.

Sometimes it takes another picture later, sometimes a day after the introduction of the RFP, then the patient is allowed to leave the hospital. He should be back at the appointed time.

Usually the doctor recommends that the patient stay in hospital for some time after the end of the procedure, at least 30 minutes. This precaution will allow to protect the patient in the event of any complications, both in connection with the bone scan, and its general condition.

modes of study

If only one picture, the procedure is called static bone scan. this may not be enough to monitor the process of development. Then, a series of snapshots or continuous scanning - dynamic scintigraphy.

It includes three phases.

1. In the first minutes of the study evaluated the intensity of the blood flow in the affected area.
2. Then it is necessary to determine how a radioactive substance distributed in the intended tumor.
3. The final distribution of the drug in all bones evaluated after 2 - 3 hours.

Your doctor may find it necessary to follow the hyperemia bones a day. This improves the accuracy of diagnosis of metastatic process in the bone.

Evaluation and interpretation of the results

Bone scintigraphy of the skeleton - it is a study that evaluates the condition of the whole organism. Data is first processed by a computer program, without human intervention. Specialist radiologist receives the processing result and describes it.

At the same time pay attention to:

• damage, anomalies, lesions in the bones, their number;
• background ratio token distribution and number of pathological pulses;
• the severity (intensity) of emission in the foci.

Description result bone scan radiologist-diagnostician transmits doctor, usually in the study day.

Bright portion in the scintigram does not always mean cancer. To clarify the diagnosis the physician may prescribe tomography, X-ray examinations, functional tests, biochemical tests.

Where do bone scan in Moscow and St. Petersburg

Equipment for scintigraphy is not enough common, but you can pass different types of studies in major medical centers. In Moscow and St. Petersburg, there are dozens of such institutions.

The cost of procedures is typically from 3,500 to 7,000 rubles.

In public health facilities survey can be free if it assigns a doctor.

Patients who received bone scan in Moscow, left a lot of positive feedback about the following medical centers:

name of establishment	Address	Appointments
Central Clinical Hospital of the Russian Academy of Sciences	m. Leninsky Prospect Street. Fotiyeva, d. 10; m. Yasenevo, Lithuanian Blvd., d. 1A	tel. +7(495)104-85-97
Cancer Center	m. Majakovsky, m. Belarus, 2nd Tverskaya lane d. 10	tel. +7(495)506-61-01

In St. Petersburg, the best technical and scientific base feature:

name of establishment	Address	Appointments
Russian Scientific Center of Radiology and Surgical Technologies	The village of Sand Street. Leningrad, d. 70	Reception: +7 (812) 596-85-43
First SanktPeterburgsky State Medical University	Address of the body should be pre-specified by phone	Paid medical services: tel. +7(812)429-03-33
National Medical Research Center. Almazov	The main clinical building: Str. Akkuratova, 10 (m. Specific, m. Pioneer)

Changes in the bones are found in the bone scintigraphy of the skeleton by an average of 3-5 months earlier than with other methods. This highly sensitive method. The doctor may find such small pockets that can not be seen, for example, in the X-ray. Improvement of diagnostic medical capabilities and improves the prognosis for the patient.

Registration of the article: Mila Friedan

Video of bone bone scan

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