SPECT／低剂量4排螺旋CT诊断骨转移瘤的临床价值

Evaluation of Clinical Values of 4-slice Low-dose Spiral CT in Detection of Bone Metastases

目的探讨SPECT／低剂量4排螺旋CT诊断骨良恶性病变的价值。方法对全身骨显像难于确诊的60例恶性肿瘤患者行SPECT／CT断层显像，同时获得SPECT，CT及两者的融合图像。所有病例均依据其病史、临床表现、全身骨显像、断层骨显像、X线片、CT、MRI和随访结果得出最终临床诊断。结果SPECT断层骨显像和低刺量CT对60倒患者120个病灶诊断的灵敏度分别为92．1％和76．5％，特异性分别为77．8％和66．7％，准确性分别为90．0％和75．0％．SPECT断层骨显像的灵敏度与准确性均高于低剂量CT（χ2=9．488和9．531，P〈0．01）。结论SPECT／低剂量4排螺旋CT对鉴别诊断骨良恶性病变具有较高的临床应用价值。

Objective To assess the value of the single photo emission computed tomography/4-slice low- dose spiral computed tomography（SPECT/CT） in the diagnosis of malignant bone metastases. Methods Sixty patients with malignant tumors whicll were not determined by the 99mTC-MDP whole-body bone scan, were examined by the SPECT,and the SPECT,CT and SPECT/CT fusion images were obtained simultaneously. The natures of the lesions were eventually confirmed by clinical manifestations, bone scan, tomography bone imaging, X-ray, CT, MRI, and ibllow-up re- suits. Results The diagnostic sensitivity of 120 lesions in 60 patients of SPECT tomography and low dose CT bone ima- ging was 92.1% and 76.5% , the specificity was 77.8% and 66.7%, and the accuracy was 90.0% and 75.0%. These shows that the sensiivity and accuracy of SPECT tomography is higher than that of low-dose spiral CT（χ2 = 9. 488,9. 531 ,P 〈 0.01 ）. Conclusion The 4-slice low-dose spiral CT can effectively differentiate the benign bone lesions from the malignant ones.