SPECT/CT与传统X线片在诊断骨转移瘤中的应用价值

The Application Value of SPECT/CT and the Conventional X-ray Film in the Diagnosis of Bone Metastases

目的探讨SPECT/CT与传统X线片在诊断骨转移瘤中的应用价值。方法回顾性分析在自贡市第四人民医院经手术或病理检查确诊为恶性肿瘤的患者42例,行传统X线片或SPECT/CT检查了解有无骨转移,结果发现阳性病灶53处,对这53处病灶分别采用传统X线片和SPECT/CT进行检查对比和随访,以X线片或CT表现为成骨或/和溶骨性骨质破坏,同时SPECT/CT显示局部放射性核素浓聚为确诊肿瘤骨转移标准,比较传统X线片和SPECT/CT诊断骨转移瘤的准确度、灵敏度及特异度。结果 X线片诊断骨转移灶的灵敏度及准确度与SPECT/CT检查比较,差异有统计学意义(灵敏度:McNemar′P<0.001;准确度:McNemar′P<0.001);X线片诊断骨转移灶的特异度与SPECT/CT大致相同,差异无统计学意义(McNemar′P=0.117)。结论相对于传统X线片检查,SPECT/CT诊断骨转移瘤具有明显优越性。

Objective To investigate the application value of SPECT/CT and the conventional X-ray film in the diagnosis of hone metastases. Methods The data of 42 cases with malignant tumors diagnosed by operation or pathology in Zigong Fourth People＇s Hospital was analyzed retrospectively. The Traditional X-ray or SPECT/CT examinations were performed to detect whether there were any bone metastases and 53 positive lesions were found. Then the 53 lesions were examined and followed up to compare by the conventional X-ray and SPECT/CT respectively. The criteria whether the results of the conventional X-ray and SPECT/CT examinations showed osteogenesis or/and osteolytic destruction of hone and the results of the SPECT/CT examination showed local radionuclide concentration were taken for the diagnosis of tumor hone metastasis in order to compare the accuracy, sensitivity and specificity of the conventional X-ray film and SPECT/CT respectively. Results The sensitivity and accuracy of the conventional X-ray film were significantly lower than those of SPECT/CT in the diagnosis of bone metastases respectively （McNemar＇ P〈0. 001）, while its specificity was roughly the same as that of SPECT/CT and there was no significant differences between them （MeNemar＇ P = 0. 117）. Conclusion Compared with the conventional X-ray examination, SPECT/CT has obvious advantages in the diagnosis of bone metastases.