PET/CT技术在非典型脊柱结核诊断中的应用

The application of the PET/CT technology in the diagnosis of atypical spinal tuberculosis

目的分析PET/CT技术在非典型脊柱结核影像诊断中的作用。方法收集2010—2016年因脊柱病变在浙江省人民医院行PET/CT检查的60例患者的X光片、CT及PET/CT检查资料,以病理诊断为金标准,采用ROC曲线比较这3种诊断方法的准确性,并描述PET/CT检查的影像学特征。结果 60例患者中,男性52例,女性8例;年龄38~82岁,平均50.2岁。3种影像诊断的统计分析结果显示,PET/CT诊断脊柱结核灵敏度为0.850,特异度为0.950,诊断准确性最高(AUC=0.900,P<0.05);PET/CT融合解剖和功能检查,可发现病灶内存在放射性"冷区"、椎旁"放射性冷脓肿"等特征性表现。PET/CT影像可分为单脊椎型结核、椎间盘型结核和多发性脊柱结核3种类型。结论采用PET/CT技术诊断非典型脊柱结核的准确性高于X线和CT,在难以诊断或怀疑脊柱转移瘤患者中值得推广应用。

Objective To explore the diagnostic value of PET/CT technique in the atypical spinal tuberculosis. Methods A total of 60 patients who had suffered from spinal tuberculosis and spinal metastasis confirmed by surgical interventions from 2010 to 2016 were retrospectively analyzed.18F-FDG PET/CT examination was made at our department. Image data of X-ray,CT,and PET/CT were compared in the diagnosis accuracy. Results A total of 52 males and 8 females,aged from 38 to 82 years(mean, 50.2 years) were collected. The statistical analysis showed PET/CT technology with sensitivity of 85%,and specificity of 95%,which were significantly higher than those of X-ray and CT(AUC=0.900,P <0.05).18F-FDG PET/CT can find more lesions than X-ray and CT,find 'cold abscess' and 'cold zone' of spinal tuberculosis,that was an exclusive value of PET/CT diagnosis for atypical spinal tuberculosis. Conclusion18F-FDG PET/CT shows an important clinical diagnostic value for the atypical spinal tuberculosis.