Capacidad discriminatoria de la gammagrafía ósea con SPECT y la tomografía axial computarizada para la localización del origen (niveles) del dolor lumbar crónico

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dc.contributor.advisorMorales Avellaneda, Tatiana
dc.contributor.authorPaternina Páez, Alejandro Enrique
dc.contributor.corporatenameSPECT Medicina Nuclear SASspa
dc.contributor.cvlacPaternina Páez, Alejandro Enrique[0001839522]spa
dc.contributor.orcidPaternina Páez, Alejandro Enrique[0009-0000-1460-2721]spa
dc.coverage.campusUNAB Campus Bucaramangaspa
dc.coverage.spatialFloridablancaspa
dc.date.accessioned2025-05-05T15:58:08Z
dc.date.available2025-05-05T15:58:08Z
dc.date.issued2025-04-28
dc.degree.nameEspecialista en Medicina Nuclearspa
dc.description.abstractEl dolor lumbar crónico (DLC) es una causa importante de discapacidad global, cuyo diagnóstico se ve dificultado por su etiología multifactorial y la limitada correlación entre hallazgos clínicos y radiológicos. Este estudio incluyó a 129 pacientes entre enero de 2023 y junio de 2024, comparando la capacidad discriminatoria y la concordancia diagnóstica de la gammagrafía ósea con SPECT y la tomografía axial computarizada (TAC) para localizar el origen vertebral del dolor. Se encontró una concordancia moderada en L1-L2 (Kappa = 0.42) y baja en otros niveles, con la SPECT mostrando mayor sensibilidad, especialmente en L3-L4 y L4-L5, aunque con menor especificidad. El mayor poder discriminatorio de la SPECT se evidenció en L1-L2 (AUC = 0.81). Se concluye que la SPECT ofrece ventajas funcionales clave, complementando a la TAC y mejorando la precisión diagnóstica y las decisiones terapéuticasspa
dc.description.abstractenglishChronic low back pain (CLBP) is a major cause of global disability, with diagnosis challenged by its multifactorial etiology and the limited correlation between clinical and radiological findings. This study included 129 patients between January 2023 and June 2024, comparing the discriminatory capacity and diagnostic concordance of bone scintigraphy with SPECT and computed tomography (CT) for localizing the vertebral origin of pain. Moderate concordance was found at the L1-L2 level (Kappa = 0.42) and low concordance at other levels, with SPECT showing greater sensitivity, particularly at L3-L4 and L4-L5, although with lower specificity. The highest discriminatory power of SPECT was observed at L1-L2 (AUC = 0.81). It is concluded that SPECT provides key functional advantages, complementing CT and improving diagnostic accuracy and therapeutic decision-making.spa
dc.description.degreelevelEspecializaciónspa
dc.description.learningmodalityModalidad Presencialspa
dc.description.tableofcontentsTABLA DE CONTENIDO 1. INTRODUCCIÓN 5 2. DESCRIPCIÓN DEL PROBLEMA 8 2.1. PLANTEAMIENTO DEL PROBLEMA 8 2.2. JUSTIFICACIÓN 10 2.3. PREGUNTA DE INVESTIGACIÓN 11 3. MARCO TEÓRICO 12 3.1. GENERALIDADES 12 3.2. ANATOMÍA FUNCIONAL 13 3.3. CAUSAS DE DOLOR 16 3.3.1. Condiciones Patológicas 17 3.4. DIAGNÓSTICO 22 3.5. IMÁGENES ANATÓMICAS DIAGNÓSTICAS 23 3.5.1. Radiografía simple: 23 3.5.2. Tomografía axial Computarizada 23 3.5.3. Imagen de resonancia magnética 23 3.6. IMÁGENES DE RADIONÚCLIDOS 25 3.6.1. Gammagrafía ósea planar 25 3.6.2. Tomografía computarizada por emisión de fotón único (SPECT) 25 3.6.3. Predicción de la respuesta al tratamiento 25 3.6.4. Tomografía computarizada por emisión de fotón único/tomografía computarizada 26 3.7. EL PAPEL DE LA IMAGENOLOGÍA EN EL TRATAMIENTO 26 3.7.1. Bloqueos intraarticulares guiados por imágenes 26 4. ESTADO DEL ARTE. 28 5. OBJETIVOS 33 5.1. OBJETIVO GENERAL 33 5.2. OBJETIVOS ESPECÍFICOS 33 6. METODOLOGÍA 34 6.1. TIPO DE ESTUDIO 34 6.2. POBLACIÓN 34 6.3. CRITERIOS DE INCLUSIÓN 34 6.4. CRITERIOS DE EXCLUSIÓN 34 6.5. CÁLCULO DE TAMAÑO DE MUESTRA 35 6.6. RECOLECCIÓN DE LA INFORMACIÓN 35 6.7. VARIABLES 36 6.8. PLAN DE ANÁLISIS 38 6.9. CONSIDERACIONES ÉTICAS 39 7. RESULTADOS 41 7.1. CARACTERIZACIÓN GENERAL DE LA POBLACIÓN DE ESTUDIO 41 7.2. ANÁLISIS BIVARIADO 44 8. DISCUSION 47 9. CONCLUSIONES 49 10. BIBLIOGRAFÍA 50spa
dc.format.mimetypeapplication/pdfspa
dc.identifier.instnameinstname:Universidad Autónoma de Bucaramanga - UNABspa
dc.identifier.reponamereponame:Repositorio Institucional UNABspa
dc.identifier.repourlrepourl:https://repository.unab.edu.cospa
dc.identifier.urihttp://hdl.handle.net/20.500.12749/29021
dc.language.isospaspa
dc.publisher.facultyFacultad Ciencias de la Saludspa
dc.publisher.grantorUniversidad Autónoma de Bucaramanga UNABspa
dc.publisher.programEspecialización en Medicina Nuclearspa
dc.publisher.programidEMN-1322
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dc.rights.accessrightsinfo:eu-repo/semantics/openAccessspa
dc.rights.creativecommonsAtribución-NoComercial-SinDerivadas 2.5 Colombia*
dc.rights.localAbierto (Texto Completo)spa
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/2.5/co/*
dc.subject.keywordsMedical sciencesspa
dc.subject.keywordsHealth sciencesspa
dc.subject.keywordsNuclear medicinespa
dc.subject.keywordsRadiationspa
dc.subject.keywordsPhysiological effectspa
dc.subject.keywordsChronic low back pain, Bone scintigraphy, SPECT, Computed tomography (CT), Diagnostic concordance, Discriminatory capacityspa
dc.subject.lembCiencias médicasspa
dc.subject.lembMedicina nuclearspa
dc.subject.lembRadiaciónspa
dc.subject.lembEfectos fisiológicosspa
dc.subject.proposalCiencias de la saludspa
dc.subject.proposalDolor lumbarspa
dc.subject.proposalGammagrafía ósea,spa
dc.subject.proposalTomografía axial computarizada,spa
dc.subject.proposalConcordanciaspa
dc.subject.proposalCapacidad discriminatoriaspa
dc.titleCapacidad discriminatoria de la gammagrafía ósea con SPECT y la tomografía axial computarizada para la localización del origen (niveles) del dolor lumbar crónicospa
dc.title.translatedDiscriminatory capacity of bone scintigraphy with SPECT and computed tomography for the localization of the origin (levels) of chronic low back painspa
dc.type.coarhttp://purl.org/coar/resource_type/c_bdcc
dc.type.coarversionhttp://purl.org/coar/version/c_b1a7d7d4d402bccespa
dc.type.driverinfo:eu-repo/semantics/masterThesis
dc.type.hasversioninfo:eu-repo/semantics/acceptedVersion
dc.type.localTesisspa
dc.type.redcolhttp://purl.org/redcol/resource_type/TM

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