单个腰椎孤立病灶行SPECT-CT断层显像的初步应用

The Primary Application of SPECT-CT Tomography Imaging in Single Lesion of Lumbar Vertebrae

目的探讨单个腰椎孤立病灶行SPECT-CT断层显像的诊断价值。方法选择20例在全身骨显像图像上只发现腰椎单个病灶的患者,再进行病变部位的SPECT-CT断层显像。将所得数据通过Astonish的重建方法进行重建并与同机CT图像融合后,由两位经验丰富的阅片医生进行阅片,所得结果与其他影像学检查(CT或MRI或PET-CT)或病理学结果进行比对。结果 SPECT-CT诊断的符合率为95%。20例中有12例为腰椎退行性改变,与其他检查结果相符,其中8例SPECT-CT融合图像示浓聚点位于椎体上、下关节突关节,2例位于椎体前缘,2例位于椎体下缘;7例患者提示椎体恶性病变;1例压缩性骨折。结论 SPECT-CT断层融合显像结合了螺旋CT的定位及精细诊断功能,能提供更多信息,对腰椎孤立性病灶的定位、定性诊断有重要价值,具有较高的敏感性和特异性。

Objective To evaluate the diagnostic value of SPECT-CT tomography imaging in single lesion of lumbar vertebrae.Methods 20 patients chosen whose 99mTc-MDP imaging showed single lesion of lumbar vertebrae were accepted SPECT-CT tomography imaging.The data would be reconstructed by Astonish,and to fuse the new data with CT images.Two experienced physicians read the images and contrasted the results with other imaging studies（CT or MRI or PET-CT）,or pathology diagnosis.Results The coincidence rate was 95%.12 cases had degenerative changes of lumbar vertebrae,SPECT-CT fusion images showed lesion was on the zygapophysial joints in 8 cases of these cases,2 cases were on the anterior vertebral border,and 2 cases were on the inferior border;7 cases were vertebral malignant lesions;one case was compression fracture.Conclusion With the diagnostic CT,SPECT-CT fusion imaging can give the accurate diagnosis and differentiate malignancy from optimum in single lesion of lumbar vertebrae.Its good sensitivity and specificity have important value for location diagnosis and qualitative diagnosis of single lesion of lumbar vertebrae.