陈旧性和新鲜骨质疏松椎体骨折患者的SPECT/CT显像浓聚程度比较

Comparison of SPECT/CT imaging concentration degree between patients with old and fresh osteoporotic vertebral fractures

目的探讨单光子发射计算机化断层扫描/体层摄影同机融合(SPECT/CT)显像鉴别诊断陈旧性与新鲜骨质疏松性椎体压缩骨折(OVCF)的临床价值。方法回顾性分析132例(162椎)OVCF患者临床资料,分为陈旧组(椎数=43)与新鲜组(椎数=119)。比较两组伤椎最大标准化摄取值(SUV max)差异,通过受试者工作特征(ROC)曲线表征其鉴别诊断价值。结果陈旧组伤椎SUV max水平(2.90±0.82)明显低于新鲜组(3.44±1.19),差异有统计学意义(t=2.750,P=0.007)。ROC曲线所示,SUV max鉴别诊断陈旧性与新鲜OVCF的曲线下面积(AUC)为0.643(95%CI=0.558~0.728),约登指数0.321(灵敏度34.45%,特异度93.02%),临界值3.88,采用临界值鉴别诊断准确度为50.00%(81/162)。结论陈旧性与新鲜OVCF在SPECT/CT显像下浓聚程度存在显著性差异,临床可借此加以鉴别,为手术治疗提供更充足诊断信息。

Objective To explore the clinical value of single photon emission computed tomography/computed tomography fusion(SPECT/CT)imaging in the differential diagnosis of old and fresh osteoporotic vertebral compression fractures(OVCF).Methods The clinical data of 132 OVCF patients(162 vertebrae)were retrospectively analyzed.The patients were divided into old group(vertebrae quantity=43)and fresh group(vertebrae quantity=119).The maximum standardized uptake value(SUV max)of injured vertebrae was compared between the two groups.The differential diagnosis value was analyzed by the receiver operating characteristic curve(ROC)analysis.Results The SUV max level of injured vertebrae in the old group(2.90±0.82)was significantly lower than that in fresh group(3.44±1.19)(t=2.750,P=0.007).As shown by the ROC analysis,the area under the curve(AUC)of SUV max in the differential diagnosis of old and fresh OVCF was 0.643(95%CI=0.558~0.728),and the Yoden index was 0.321(sensitivity=34.45%and specificity=93.02%).The cut-off value was 3.88,and the diagnostic accuracy of critical value was 50.00%(81/162).Conclusion There is a significant difference in the concentration degree under SPECT/CT imaging between old and fresh OVCF,and the difference can be used in clinical identification to provide more diagnostic information for surgical treatment.