医学影像存档与通信系统在骨显像肋骨单发浓聚灶中的应用价值

Application value of picture archiving and communication system in patients with solitary hot spots in ribs on bone scintigraphy

目的探讨医学影像存档与通信系统(PACS)在骨显像肋骨单发浓聚灶诊断中的应用价值。方法应用PACS回顾性分析84例肋骨单发浓聚灶患者骨显像及胸部CT影像资料。根据骨显像单独诊断、CT单独诊断及二者联合诊断计算并比较三种情况下的诊断准确性。所有肋骨单发病灶的最终诊断经随访、相关综合影像或病理活检证实。结果骨显像对全部84例肋骨单发浓聚灶的诊断准确性仅为21.4%(18/84),诊断不确定者占77.4%(65/84),对全部病例中19处肋骨条形单发浓聚灶的诊断准确性为94.7%(18/19)。胸部CT对全部病例肋骨单发浓聚灶的漏诊率为14.3%(12/84);对全部病例而言,其诊断准确性为77.4%(65/84)。对全部84例肋骨单发浓聚灶而言,通过PACS联合骨显像和CT诊断准确性为91.7%(77/84),与单独骨显像或单独CT诊断相比有明显提高,差异均具有统计学意义(χ2分别为84.3和6.6,P<0.05)。结论应用PACS系统能共享影像资源,能明显提高对骨显像肋骨单发浓聚灶的诊断准确性,具有较佳的临床实用价值。

Objective To discuss the application value of picture archiving and communication system （PACS）in diagnosing patients with solitary hot spots in ribs on bone scintigraphy（BS）. Methods BS and thoracic CT data were retrospectively analyzed using PACS for 84 cases with solitary hot spots in ribs on BS. Diagnostic accuracy was calculated and compared among combination of BS and CT using PACS, BS alone and CT alone, respectively. Final diagnoses were confirmed through fellow-up, relative imaging data or pathology for solitary lesions in ribs. Results The diagnostic accuracy of BS alone was 21.4% （18/84） for 84 cases with solitary hot spots in ribs,and 94. 7% （18/19）for patients with strip hot spots in ribs. Uncertain diagnoses with BS occupied 77. 4% （65/ 84） among all the cases. The rate of missed diagnoses for CT alone was 14. 3% （12/84） ,and the diagnostic accuracy of CT alone was 77.4% （65/84） for all patients. The diagnostic accuracy of combined BS and CT using PACS was 91.7% （77/84）for the total eighty six patients, which had statistical differences compared with BS （X^2 = 84. 3, P 〈 0. 05） or CT alone （X^2 = 6.6, P 〈 0.05）. Conclusions It is an efficient way to increase the diagnostic accuracy for patients with solitary hot spots in ribs on BS by sharing medical resources using PACS, which shows excellent practical values.