SPECT/CT骨显像与MRI对足踝部病变诊断价值的比较

SPECT/CT Bone Imaging and MRI in the Diagnosis of Foot and Ankle Lesions: A Comparative Study

目的通过对足踝部不同类型病变的分析及与MRI对比,探讨SPECT/CT对足踝部病变的诊断价值。资料与方法回顾性分析76例因足踝部疼痛且患足未行手术治疗、行足踝部SPECT/CT与MRI检查的患者,以检查后手术结果为“金标准”,分别计算SPECT/CT与MRI对足踝部骨病变、关节病变、软组织病变的敏感度、特异度等,比较SPECT/CT与MRI对足踝部病变的诊断价值。结果SPECT/CT与MRI对足踝部病变的总体诊断敏感度、特异度分别为76%、61%和81%、56%,差异无统计学异意义(均P>0.05)。SPECT/CT对足踝部骨病变的敏感度(95%)高于MRI(80%,P<0.005),对足踝部软组织病变的特异度(84%)明显高于MRI(42%,P<0.001)。SPECT/CT和MRI联合诊断足踝部病变的总体敏感度、特异度为98%、57%,其敏感度高于单独使用SPECT/CT或MRI(均P<0.05)。结论SPECT/CT与MRI比较,对足踝部病变的总体诊断价值相当,而对足踝部骨病变的敏感度较高,对软组织病变的特异度较高,两者联合可提高诊断价值。

Purpose To investigate the diagnostic value of SPECT/CT for foot and ankle lesions by analyzing different types of foot and ankle lesions and comparing with MRI.Materials and Methods A retrospective analysis was performed on 76 patients with foot and ankle pain who had not undergone surgical treatment and had undergone SPECT/CT as well as MRI examinations of the foot and ankle.The postoperative results of the examination were the"gold standard"and SPECT/CT were calculated separately.The diagnostic value of SPECT/CT and MRI for foot and ankle lesions was compared with that of MRI for foot and ankle bone lesions,joint lesions and soft tissue lesions.Results The overall diagnostic sensitivity and specificity of SPECT/CT and MRI for foot and ankle lesions were 76%,61%and 81%,56%,respectively,there was no significant difference between them(all P>0.05).The sensitivity of SPECT/CT to foot and ankle bone lesions(95%)was higher than MRI(80%,P<0.005),and the specificity of foot and ankle soft tissue lesions(84%)was significantly higher than MRI(42%,P<0.001).The overall sensitivity and specificity of SPECT/CT and MRI in the diagnosis of foot and ankle lesions were 98%and 57%,and their sensitivity was higher than that of SPECT/CT or MRI alone(both P<0.05).Conclusion Compared with MRI,SPECT/CT has the same overall diagnostic value for foot and ankle lesions,but it is more sensitive to foot and ankle bone lesions and more specific to soft tissue lesions.The combination of them can improve the diagnostic value.