SPECT/CT融合显像对脊柱和肋骨单发浓聚灶的鉴别诊断价值

Value of SPECT with 2.5mA X-ray Tube Fusion Imaging in Differential Diagnosis for Single Hot Spots of Spine and Ribs

[目的]评价SPECT配置2.5mA X射线球管装置系统融合显像对脊柱、肋骨单发浓聚灶良恶性病变的鉴别诊断价值。[方法]选取在全身骨显像中表现为脊柱、肋骨单发浓聚灶的98例恶性肿瘤患者,同时行SPECT配置2.5mA X射线球管装置系统融合显像。并以CT、MRI结果或6-12个月的随访作为最终临床诊断结果,分析全身骨显像和SPECT配置2.5mA X射线球管装置系统融合显像的鉴别诊断效能。[结果]SPECT配置2.5mA X射线球管装置系统融合显像诊断单发浓聚灶骨转移的敏感性84.21%,特异性91.67%,准确性88.78%,阳性预测值86.49%,阴性预测值90.16%。全身骨显像诊断单发浓聚灶骨转移的敏感性60.53%,特异性71.67%,准确性67.35%,阳性预测值57.50%,阴性预测值74.14%。二者敏感性相比差异有统计学意义（P〈0.05）,特异性和准确性差异均有显著统计学意义（P〈0.01）。[结论]SPECT配置2.5mA X射线球管装置系统融合显像可提高对脊柱和肋骨单发浓聚灶良恶性病变的鉴别诊断能力。

[Purpose] To evaluate the differential diagnostic value of SPECT with 2.SmA X-ray tube fusion imaging for benign or malignant single hot spots in spine and ribs. [Methods] Ninty-eight patients of malignant tumor with single hot spots of spine and ribs in bone scan were cho- sen, and then SPECT with 2.5mA X-ray tube scan was performed. All patients were diagnosed by CT, MRI or followed up more than 6 months. The differences of the diagnosis of SPECT bone imaging and SPECT with 2.SmA X-ray tube fused imaging were analyzed. [Results] Sensitivity of diagnosis of the metastatic bone tumor with SPECT with 2.SmA X-ray tube in single hot spots of spine and ribs was 84.21% ,with specificity 91.67% ,coincidence 88.78% ,positive predictive value 86.49% ,negative predictive value 90.16%. Sensitivity of diagnosis of the metastatic bone tumor with bone imaging in single hot spots of spine and ribs was 60.53% ,with specificity 71.67%, coincidence 67.35%, positive predictive value 57.50%, negative predictive value 74.14%. SPECT with 2.SmA X-ray tube had difference with bone imaging in sensitivity （P〈0.05）, and sig- nificant differences in coincidence and specificity（P〈0.01）. [Conclusion] SPECT with 2.SmA X- ray tube fusion imaging might improve differential diagnosis level for benign or malignant of single hot spots in spine and ribs.