SPECT联合MDCT、MRI多模态显像对骨转移瘤诊断价值的研究

The value of SPECT combined with MDCT and MRI in the diagnosis of bone metastatic tumors

目的探讨SPECT联合MDCT、MRI多模态显像对骨转移瘤诊断效能差异,为骨转移瘤患者选择合适的影像诊断方法提供依据,避免过度检查。方法回顾性分析79例疑似骨转移瘤患者的SPECT、MDCT及MRI图像,对各种检查图像进行判读,分别记录各种检查图像中骨异常灶的性质及数量,对其检查结果进行分析。结果79例患者中SPECT、MDCT、MRI、SPECT+MDCT、SPECT+MRI、SPECT+MDCT+MRI检查分别对骨转移瘤的准确率依次为60.7%(48/79)、54.4%(43/79)、65.8%(52/79)、81%(64/79)、86.1%(68/79)、87.3%(69/79)。其中SPECT与SPECT+MDCT(2=7.851,P<0.05)、SPECT与SPECT+MRI(2=12.972,P<0.05)、SPECT与SPECT+MDCT+MRI(2=14.525,P<0.05)组间对比,在骨转移瘤诊断准确率上有显著差异,有统计学意义(P<0.05);而SPECT+MDCT与SPECT+MRI(2=0.737,P=0.391)、SPECT+MDCT与SPECT+MDCT+MRI(2=1.188,P=0.276)、SPECT+MRI与SPECT+MDCT+MRI(2=0.055,P=0.815)组间对比,在骨转移瘤诊断确诊率上差异不明显,无统计学意义(P>0.05)。结论多模态影像检查联合应用(尤其是SPECT+MDCT、SPECT+MRI或SPECT+MDCT+MRI)能够对临床骨转移瘤的患者做到早发现、早诊断、早治疗,以降低病灶的假阳性率,提高影像诊断的准确率,从而达到精准诊疗的目的。

Objective To explore the difference between SPECT and MDCT and MRI multi-mode imaging in the diagnosis of tumor bone metastasis.Methods The SPECT,MDCT and MRI images of 79 patients with suspected tumor bone metastasis were retrospectively analyzed.Various examination images were interpreted,and the nature and number of abnormal bone lesions in various examination images were recorded,and the results were analyzed and studied.Results The accuracy of SPECT,MDCT,MRI,SPECT+MDCT,SPECT+MRI and MRI in 79 patients was 60.7%(48/79),54.4%(43/79)and 65.8%(52/79)(respectively),81%(64/79),86.1%(68/79),87.3%(69/79).SPECT and SPECT+MDCT(2=7.851,P<0.05),SPECT and SPECT+MRI(2=12.972,P<0.05),SPECT and SPECT+MDCT+MRI(2=14.525,P<0.05).There was a significant difference in the diagnostic accuracy of tumor bone metastasis between groups(P<0.05);SPECT+MDCT and SPECT+MRI(2=0.737,P=0.391),SPECT+MDCT and SPECT+MDCT+MRI(2=1.188,Comparison between P=0.276),SPECT+MRI and SPECT+MDCT+MRI(2=0.055,P=0.815)showed no significant difference in the diagnosis rate of tumor bone metastasis and no statistical significance(P<0.05).Conclusion Multi-modal imaging combined applications(especially SPECT+MDCT,SPECT+MRI,or SPECT+MDCT+MRI)can achieve early detection,early diagnosis,and early treatment of patients with clinical bone metastatic tumors to reduce the pseudopositive rate of the lesion,to improve the accuracy of imaging diagnosis,so as to achieve the purpose of accurate diagnosis and treatment.