SPECT/CT融合骨显像对乳腺癌骨转移的诊断价值

The Diagnostic Value of SPECT/CT Fusion Bone Imaging for Bone Metastases of Breast Cancer

目的探讨SPECT/CT融合骨显像对乳腺癌骨转移的诊断价值。方法 96例乳腺癌可疑骨转移的患者,静脉注射^(99)mTc-MDP 740~1110 MBq,3~6 h后按常规方法行SPECT全身骨显像,对发现的可疑病灶行SPECT/CT融合显像。由两位核医学科医师先对全身骨显像的平面图像进行分析,然后分析SPECT/CT融合图像并诊断,诊断分为肿瘤骨转移和无骨转移。诊断结果分别与病理或随访获得的正确诊断比较,并计算全身骨显像、SPECT/CT融合显像对患者诊断的灵敏度、特异性及符合率,采用SPSS 16.0软件,对全身平面显像和SPECT/CT融合显像两组数据的差异进行χ~2检验,P<0.05为差异有统计学意义。结果 96例乳腺癌患者最终诊断为骨转移者53例,无肿瘤骨转移者43例。全身骨显像诊断肿瘤骨转移40例,灵敏度为75.5%(40/53),无肿瘤骨转移28例,特异性为65.1%(28/43),全身骨显像诊断与最终诊断结果符合68例,诊断符合率为70.8%(68/96);SPECT/CT融合骨显像诊断的灵敏度为94.3%(50/53),特异性为95.3%(41/43),诊断符合率为94.8%(91/96),SPECT/CT融合显像诊断的灵敏度、特异性及符合率均明显高于全身平面显像诊断,差异有统计学意义(χ~2=7.36、12.39、19.36,P均<0.05)。结论 SPECT/CT融合骨显像能够提供明确的定位、定性诊断,在乳腺癌骨转移诊断中较全身骨显像有更大的临床应用价值。

Objective To investigate the value of SPECT / CT fusion bone imaging in the diagnosis of bone metastasis of breast cancer. Methods For 96 patients with breast cancer with suspected bone metastasis,intravenous injection of ^99mTc-MDP 740 - 1110 MBq,SPECT total body bone imaging was performed by routine method after 3 - 6h. SPECT / CT fusion imaging was performed to find the suspicious lesions. Two nuclear medicine physicians first made an analysis of the whole body bone imaging plane image,and then analyze the SPECT / CT fusion image and made the diagnosis. The diagnosis is divided into tumor bone metastasis and non bone metastasis. The diagnostic results were compared with the correct diagnosis of pathology or follow up,and the sensitivity,specificity and coincidence rate of the diagnosis of the patients were calculated by the whole body bone imaging and SPECT / CT fusion imaging. Using SPSS 16. 0 software,the difference of body imaging and SPECT / CT imaging data of two groups were analyzed by χ^2test. The difference was statistically significant when P 0. 05. Results Fifty- three of 96 patients were comfirmed to suffer metastasis,43 to be with non- metastasis. The sensitivity,specificity,and coincidence rate of the whole body bone imaging were 75. 5%（ 40 /53）,65. 1%（ 28 /43） and 70. 8%（ 68 /96）. Those of the SPECT / CT fusion imaging were 94. 3%（ 50 /53）,95. 3%（ 41 /43） and 94. 8%（ 91 /96）. The sensitivity,specificity and accuracy of SPECT / CT fusion imaging diagnosis were significantly higher than that of general planar imaging diagnosis. The difference was statistically significant（ χ^2= 7. 36,12. 39,19. 36,P 0. 05）. Conclusion The SPECT / CT fusion bone imaging can provide a clear positioning,qualitative diagnosis,and has more clinical application value than the whole body bone imaging in breast cancer bone metastases.