SPECT/CT骨显像对骨转移性病灶的诊断价值

The fusion imaging of SPECT/CT for differential diagnosis in bony metastasis disease

目的评价单光子发射计算机断层显像(SPECT)/X线计算机断层显像(CT)在脊柱、肋骨良恶性病变中的诊断价值。方法对全身骨显像中表现为脊柱、肋骨出现异常核素浓聚灶(病灶数目≤3个)的患者,行局部骨断层,同时获得局部骨断层图像、同机定位CT图像以及两者的融合图像。所有病例均以病理、磁共振结果或1年以上随诊为最终诊断结果。结果41例患者85处病灶中,42处诊断为肿瘤骨转移,占总病灶数的49.4%;43处诊断为良性病变,占总病灶数的50.6%。全身骨显像与SPECT/CT对病灶诊断的敏感性分别为90.5%、97.6%,特异性分别为16.3%、93.0%,准确性分别为52.9%、95.0%。结论SPECT/CT可以明显提高脊柱、肋骨病灶诊断的特异性和准确性,对鉴别脊柱、肋骨良恶性病变有重要的临床应用价值。

Objective To evaluate the fusion imaging of SPECT/CT for differential diagnosis of benign and malignant spinal and rib disease.Methods 99Tcm-MDP SPECT/CT was performed in 41 patients with abnormal uptake in spine and rib （number≤3） by 99Tcm-MDP scanning,which produced 99Tcm-MDP SPECT,low-dose CT and fusion imaging.All patients were diagnosed by MRI,pathology or follow-up more than one year.Results In 41 patients,85 lesions detected in whole body scan,it included 42 malignant lesions and 43 benign lesions.The diagnostic sensitivity of 99Tcm-MDP SPECT and fusion imaging for 85 lesions was respectively 90.5% and 97.6%.The specificity of two type of imaging was respectively 16.3% and 93.0%.The accuracy of two type of imaging was respectively 52.9% and 95.2%.The fusion imaging of SPECT/CT may improve the specificity and the accuracy to diagnosis of benign and malignant spinal and rib disease.Conclusion SPECT/CT scan is clinically valuable in differentiating malignancy from benignancy in single spinal disease.