SPECT及CT对首诊肺癌患者骨转移的诊断价值

Value of SPECT and CT in detecting bone metastases in patients with newly diagnosed lung cancer

目的探讨SPECT全身骨静态显像、胸部CT及二者联合对首诊肺癌患者骨转移的诊断价值。方法回顾性分析236例肺癌患者首诊时的SPECT全身骨静态显像及胸部CT资料,比较各自及两者联合对骨转移瘤的诊断价值。结果 SPECT确诊骨转移38例,CT确诊32例,两者差异无统计学意义;综合分析确诊44例,显著减少了不确定病例数。经综合分析,共确诊172处转移病灶,128处(128/172,74.42%)位于CT扫描范围内,44处(44/172,25.58%)位于CT扫描范围外;CT扫描范围内的128处病灶中SPECT显示阳性123处(123/128,96.09%),CT显示阳性106处(106/128,82.81%),两者差异有统计学意义。结论 SPECT全身骨静态显像及胸部CT均为诊断肺癌骨转移的有效方法,综合分析两种影像检查结果可有效提高诊断效能。

Objective To explore the diagnostic value of SPECT bone scintigraphy,thoracic CT and comprehensive analysis of these two examinations in detecting bone metastases in patients with newly diagnosed lung cancer.Methods Initial images of SPECT bone scintigraphy and thoracic CT of 236 patients with newly diagnosed lung cancer were analyzed retrospectively.SPECT bone scintigraphy,thoracic CT and comprehensive analysis of these two examinations in diagnosis of bone metastases were compared.Results Thirty-eight patients with bone metastases were diagnosed with SPECT alone and 32 patients were diagnosed with CT alone.There was no significant difference between them.Forty-four patients with bone metastases were diagnosed with comprehensive analysis of these two examinations with a significant reduction of patients with equivocal findings.There were 172 lesions of bone metastases diagnosed with comprehensive analysis,128 lesions（128/172,74.42%） localized within the range of CT scan and 44 lesions（44/172,25.58%） localized outside the range of CT scan.For 128 lesions within the range of CT scan,SPECT found 123 lesions（123/128,96.09%） and CT found 106 lesions（106/128,82.81%）,there was significant difference between them.Conclusion Both SPECT and CT are useful in detecting bone metastases in patients with newly diagnosed lung cancer.Comprehensive analysis of SPECT and CT can improve diagnostic efficiency.