SPECT/CT断层融合显像与磁共振成像对原发性骨肿瘤的诊断价值

Diagnostic value of SPECT/CT tomographic fusion imaging and magnetic resonance imaging in primary bone tumors

目的对比单光子发射计算机断层成像(SPECT/CT)与磁共振成像(MRI)在原发性骨肿瘤临床诊断中的应用价值。方法选取2016年1月至2018年1月期间本院进行原发性骨肿瘤诊治的104例患者为研究对象。分别对上述患者进行SPECT/CT和MRI检查,并将检查结果与手术病理结果相比较,比较两种检查方法对原发性骨肿瘤的诊断效能。结果⑴病理检查结果:70例为恶性肿瘤、34例为良性肿瘤;SPECT/CT检查结果:72例为恶性肿瘤,32例为良性肿瘤;MRI检查结果:76例为恶性肿瘤、28例为良性肿瘤;两种方法对原发性骨肿瘤诊断结果的差异无统计学意义(P>0.05)。⑵SPECT/CT检查诊断原发性骨肿瘤的灵敏度、特异度、准确度、阳性预测值、阴性预测值分别为92.86%、79.41%、88.46%、90.28%、84.38%,略高于MRI检查(91.43%、64.71%、82.69%、84.21%、78.57%),但差异无统计学意义(P>0.05)。⑶SPECT/CT与MRI诊断原发性骨肿瘤有较高的一致性(Kappa值=0.613)。⑷SPECT/CT对骨肉瘤、骨巨细胞瘤、骨髓瘤、骨纤维结构不良的诊断准确性较高,而MRI则对骨肉瘤、脊索瘤、尤文肉瘤、骨神经鞘瘤的诊断准确性较高。结论SPECT/CT断层融合显像与MRI诊断原发性骨肿瘤均具有较高的灵敏度和准确度,且两种诊断方法的结果有较高的一致性。SPECT/CT对骨化、骨骼钙化瘤的诊断准确性较高,而MRI对骨骼软组织和神经系统骨肿瘤有较高的诊断正确率。因此两种检查方法共同应用可相互弥补不足,对原发性骨肿瘤诊断更加准确。

Objective To study the effects of single photon emission computed tomography/computed tomography(SPECT/CT)and magnetic resonance imaging(MRI)in the diagnosis of primary bone tumors.Methods A total of 104 patients with primary bone tumors in Zibo Central Hospital hospital from January 2016 to January 2018 were enrolled in this study.SPECT/CT and MRI examinations were performed on these patients,and the results of the examinations were compared with the results of surgical pathology.The diagnostic efficacy of the two methods for primary bone tumors were compared.Results⑴Results of pathological examination:70 cases were malignant tumors,and 34 cases were benign tumors;results of SPECT/CT:72 cases were malignant tumors,and 32 cases were benign tumors;MRI:76 cases were malignant tumors,and 28 cases were benign tumors;there was no difference between the two methods in the diagnosis of primary bone tumors.⑵The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of SPECT/CT were 92.86%,79.41%,88.46%,90.28%and 84.38%respectively,slightly higher than those of MRI(91.43%,64.71%,82.69%,84.21%and 78.57%),but the difference was not statistically significant(P>0.05).⑶There was a high consistency between SPECT/CT and MRI in the diagnosis of primary bone tumors(Kappa value=0.613).⑷SPECT/CT is more accurate in the diagnosis of osteosarcoma,giant cell tumor,myeloma and fibrous dysplasia,while MRI is more accurate in the diagnosis of osteosarcoma,chordoma,Ewing's sarcoma and schwannoma.Conclusions SPECT/CT fusion imaging and MRI have high sensitivity and accuracy in the diagnosis of primary bone tumors,and the results of the two diagnostic methods have high consistency.SPECT/CT has a high accuracy in the diagnosis of ossification and calcification,while MRI has a high accuracy in the diagnosis of bone tumors in bone soft tissue and nervous system.Therefore,the joint application of the two methods can make up for each other's shortcomings and make the diagnosis of primary bone tumor more accurate.