骨断层SPECT/CT显像在骨转移鉴别诊断中的应用价值

The value of ^(99m)Tc-MDP SPECT/CT bone imaging in differentiating bone metastases

目的:探讨骨断层SPECT/CT在骨转移鉴别诊断中的价值。方法:回顾分析2012年8月~2014年5月可疑骨转移的75例恶性肿瘤患者,在我科行常规99mTc-MDP全身平面骨显像及SPECT/CT断层显像,并于3~6个月后复查全身平面骨显像,比较全身平面骨显像及骨断层SPECT/CT显像的诊断效能。结果:与骨断层SPECT/CT显像相比,全身平面骨显像的特异性较高(100%)。骨断层SPECT/CT显像准确性显著高于全身平面骨显像(P<0.01)。3~6个月复查全身平面骨显像时,32例患者病变发生进展,诊断准确性较第一次全身骨扫描及骨断层SPECT/CT均有所提高。结论:骨断层SPECT/CT在骨转移鉴别诊断中准确性较高,且能早期发现骨转移病灶。

Objective：To investigate the value of bone scan with SPECT/CT in differentiating bone metastases.Methods：A retrospective study from August 2012 to May 2014 was performed on 75 patients with known cancer who underwent 99mTc-methylene diphosphonate whole-body planar bone scintigraphy and had light-middle increased tracer uptaking lesions.These lesions were then further evaluated using SPECT/CT at the same day and whole-body planar bone scintigraphy 3-6 months later.Results：Although the specificity of planar bone scans was excellent（100％）.The accuracy of SPECT/CT was higher than planar imaging,there was significant difference between two procedures.There were 32 patients with progression in planar bone scan 3-6 months later,and the accuracy of reexamination planar bone scan was higher than both of the first examination.Conclusion：The results provide evidence of a substantial incremental increase in diagnostic accuracy using SPECT/CT over planar imaging alone for patients with suspicious metastases.Bone scintigraphy with SPECT/CT has an important value in differentiate diagnosis and earlier diagnosis of bone metastases.