SPECT/CT融合显像结合同机CT多平面重组在骨转移瘤诊断中的增益价值

Additional value of SPECT/CT fusion imaging combined with multi-planar reconstitution of integrated CT in diagnosis of bone metastases

目的探讨SPECT/CT融合显像结合同机CT多平面重组(MPR)在骨转移瘤诊断中的增益价值。方法回顾性分析2016年12月至2018年10月在我院行全身骨显像+SPECT/CT局部断层融合显像的96例患者临床资料。排除“超级骨显像”及无明确随访结果者,所得图像按两种方案进行分析,其中方案一:SPECT/CT融合图像;方案二:SPECT/CT融合图像+同机CT多平面重组。统计两种方案融合图像范围内的骨病灶数目并进行分析定性,结合随访结果评价两种图像分析方案的诊断效能。结果研究纳入96例患者共197个病灶,其中转移病灶103个,良性病灶94个。方案一诊断转移病灶109个,良性病灶88个;方案二诊断转移病灶96个,良性病灶101个,两种方案诊断准确性比较差异有统计学意义(χ2=8. 470 6,P <0. 01)。结论融合显像结合同机多平面重组CT可以显著提高SPECT/CT诊断骨转移瘤的准确性,有效排除部分假阳性病例。

Objective To evaluate the additional value of SPECT/CT fusion imaging combined with multi-planar reconstitution( MPR) of integrated CT in the diagnosis of bone metastases. Methods Collected and analyzed the clinical data of 96 patients who underwent whole body bone scan and SPECT/CT local tomographic fusion imaging. Excluded the patients with "super bone scan"and who were failed to follow-up. The obtained images were analyzed with two schemes: SPECT/CT fusion image and SPECT/CT fusion image combined with MPR of integrated CT. The number of bone lesions in the fusion image was counted and qualitatively analyzed. The diagnostic efficiency of the two image analysis schemes were evaluated according to the follow-up results. The chi-square test of paired data was used to compare the data between the two groups. Results A total of 197 lesions were included in 96 patients,including 103 metastatic lesions and 94 benign lesions. A total of 109 metastatic lesions and 88 benign lesions were diagnosed by SPECT/CT fusion image,and 96 metastatic lesions and 101 benign lesions were diagnosed by SPECT/CT fusion image combined with MPR of integrated CT. The diagnostic accuracy of the two schemes was significantly different (χ^ 2 =8. 470 6,P <0. 01). Conclusion Fusion imaging combined with multi-planar reconstitution of integrated CT can significantly improve the accuracy of SPECT/CT in the diagnosis of bone metastases and effectively exclude some false-positive cases.