~99Tc^m-MDP SPECT/CT骨显像诊断恶性肿瘤骨转移的价值

Evaluation of 99~Tc^m-MDP SPECT/CT bone imaging in diagnosis of bone metastases

目的探讨^(99)Tc^m-亚甲基二膦酸盐(MDP)SPECT/CT 骨显像诊断恶性肿瘤骨转移的临床价值。方法 73例恶性肿瘤或不明原因骨痛患者行^(99)Tc^m-MDP SPECT/CT 全身骨平面和局部显像。获得全身骨平面、SPECT 断层和 CT 图像及 SPECT 与 CT 融合图像后,结合病史、临床表现进行回顾性分析。结果 SPECT/CT 骨显像可提供精确的解剖定位,发现脊柱(31处)、肋骨(11处)、胸骨(4处)、锁骨(3处)、肩胛骨(1处)、骶骨(1处)、坐骨(3处)、骶髂关节(1处)和骨外(20处)有异常放射性浓聚灶。骨骼病变的性质与病灶部位有关,如病变累及椎体和(或)椎弓根,常提示肿瘤骨转移;累及椎小关节或椎体,呈“唇样”放射性浓聚,可考虑为良性病变。若平面显像呈“热区”,CT 图像表现正常者,可考虑肿瘤骨转移。结论 SPECT/CT 骨显像诊断骨转移灶有较高临床价值。

Objective To evaluate the clinical value of ^99Tc^m-methylene diphosphonic acid （MDP） SPECT/CT imaging in diagnosis of bone metastases. Methods Seventy-three patients with malig- nant tumors or unknown bony pain underwent whole body and local bone imaging with ^99Tc^m-MDP SPECT/ CT. Related history and clinical manifestation, the whole body planar, SPECT and SPECT/CT fusion imaging were retrospectively analyzed. Results ^99Tc^m-MDP SPECT/CT could provide precise anatomical localization of focal lesions. The foei of increased activity were 31 in spines, 11 in ribs, 4 in sternums, 3 in clavicles, 1 in scapula, 1 in sacrum, 3 in sciatic bone, 1 in sacroiliac joint and 20 in extraosseous tissue. The character of bone lesions related to the location. If the focus was found at vertebral body and （or） at pedicle, osseous metastasis was usually suggested; if the focus referred to small vertabral joint or vertebral body with lip-like hot area, probably benign disease was considered. When hot area was found on SPECT but normal on CT, osseous metastasis was also suspected, Conclusion ^99Tc^m-MDP SPECT/CT has an important value in diagnosis of bone metastases.