HIGH-RESOLUTION MULTIDETECTOR SPET IMAGING OF THE PEDIATRIC SPINE

We reviewed the planar and single photon emission tomographic (SPET) s pine images of 69 paediatric patients aged 2-17 years referred for und iagnosed back pain. The SPET images were obtained using a triple-detec tor 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 rem aining 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+) cin tho SPET images. Three of the 21 cases had 2+ planar abnormalities, but SPET demonstrat ed additional uptake abnormalities. Lastly, a single case that was 2on the planar images was demonstrated to be artefactual by SPET. Thirt y-seven sites were abnormal by SPET, including 17 pedicle/pars interar ticularis (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 include d 10 of 17 (59%) in the pedicle/pars region, 9 of 10 (90%) in the spin ous process, 1 of 2 (50%) in the vertebral body and 2 of 8 (25%) in th e vertebral endplates. The improved resolution of ultra-high-resolutio n collimated multi-detector SPET permits visualization of a greater va riety of abnormalities than was seen with earlier single-detector came ras, particularly those involving the spinous process.