^(99)Tc^m-MDP SPECT/CT诊断宫颈癌放疗后骨盆不全骨折

^(99)Tc^m-MDP SPECT/CT in diagnosis of pelvic insufficiency fracture of cervical cancer after radiotherapy

目的探讨^(99 )Tc^m-MDP SPECT/CT诊断宫颈癌放疗后骨盆不全骨折(PIF)的价值。方法回顾性分析37例宫颈癌放疗后疑似PIF患者的全身显像(WBS)和骨盆SPECT/CT断层融合显像资料。以影像学资料、临床资料及随访(>12个月)结果作为最终诊断PIF的标准,比较WBS、SPECT/CT对PIF的诊断效能。结果37例患者共50个骨盆病灶,最终诊断PIF 42个(30例)。WBS诊断PIF的灵敏度为45.24%(19/42),特异度50.00%(4/8),准确率46.00%(23/50);SPECT/CT诊断PIF的灵敏度为92.86%(39/42),特异度75.00%(6/8),准确率90.00%(45/50);SPECT/CT诊断宫颈癌放疗后PIF的灵敏度及准确率均高于WBS(χ~2=22.28、22.24,P均<0.01),但二者特异度差异无统计学意义(P=0.31)。结论^(99 )Tc^m-MDP SPECT/CT可用于诊断宫颈癌放疗后PIF。

Objective To explore the value of 99 Tc m-MDP SPECT/CT in diagnosis of pelvic insufficiency fracture(PIF)of cervical cancer after radiotherapy.Methods Whole body scan(WBS)and 99 Tc m-MDP SPECT/CT data of 37 suspected PIF patients with cervical cancer after radiotherapy were retrospectively analyzed.The diagnosis standard of PIF was based on radiologic investigation,clinical information and follow up for at least 12 months.The efficiency in diagnosis of PIF was compared between WBS and SPECT/CT.Results Among 37 patients(50 pelvic lesions),42 PIF lesions were diagnosed in 30 patients.The diagnostic sensitivity,specificity and accuracy of WBS diagnosis of PIF were 45.24%(19/42),50.00%(4/8)and 46.00%(23/50),while of SPECT/CT diagnosis of PIF were 92.86%(39/42),75.00%(6/8)and 90.00%(45/50),respectively.The diagnostic sensitivity and accuracy of SPECT/CT were significantly higher than those of WBS(χ2=22.28,22.24,both P<0.01),and no significant difference of specificity was found between WBS and SPECT/CT(P=0.31).Conclusion 99 Tc m-MDP SPECT/CT can be used for diagnosis of PIF.