SPECT/CT同机融合显像鉴别诊断骨良恶性病灶的价值

SPECT/CT Fusion Imaging for the Diagnosis of Benign and Malignant Lesions in Bones

目的评价单光子发射计算机断层成像(SPECT)/CT同机融合功能解剖显像在恶性肿瘤患者中鉴别诊断骨良恶性病灶的价值。方法对全身骨显像难于确诊的125例恶性肿瘤患者的141个病灶进行SPECT/CT同机融合显像,同时获得SPECT、CT及两者的融合图像。由2名经过放射学培训的核医学科医师盲法独立阅片。所有病灶均以病理、磁共振结果或6个月以上的随访为最终诊断结果。结果SPECT、SPECT+CT和SPECT/CT对125例患者的141个病灶诊断骨转移癌的敏感性分别为82.5%、93.7%和98.4%,特异性为66.7%、80.8%和93.6%,准确性为73.8%、86.5%和95.7%。与SPECT和SPECT+CT相比,SPECT/CT诊断骨转移癌的特异性和准确性显著提高(P<0.05)。结论SPECT/CT同机融合显像对鉴别诊断骨良恶性病灶具有良好的临床应用价值。

Objective The aim of the study was to evaluate the value of the single photon emission computed tomography/computed tomography（SPECT/CT） fusion imaging in the diagnosis of benign and malignant lesions in hones. Methods One hundred and forty one bone lesions of 125 cancer patients, for whom the natures of the lesions were not able to be determined by the ^99Tc^m-MDP whole-body bone scan, were examined by the SPECT, CT and SPECT/CT fusion imaging simultaneously. All of the images were blindly interpreted independently by two experienced nuclear medicine physicians. The natures of the lesions were eventually confirmed by MRI, pathology or follow-up diagnosis six months later. Results The diagnostic sensitivity of SPECT, SPECT＋CT and SPECT/CT for the 141 bone lesions was 82.5%, 93. 7%, and 98.40% respectively. The specificity was 66. 7%, 80. 8%, and 93. 6% respectively. The accuracy was 73.8%, 86.5%, and 95.7% respectively. The specificity and accuracy of SPECT/CT for diagnosing bone lesions were significantly higher than those of SPECT and SPECT＋CT （P〈0.05）. Conclusion SPECT/CT can effectively differentiate benign and malignant hone lesions.