脊柱良恶性病变诊断:18F-FDG PET/CT与MRI对比研究

目的 分析和比较18F-FDG PET/CT和MRI对脊柱病变良恶性鉴别的诊断效能.方法 30例脊柱病变患者均进行18F-FDG PET/CT和MRI显像,计算并比较两种显像方法对脊柱病变良恶性鉴别诊断的灵敏度、特异性、准确性、阳性预测值和阴性预测值；计算并比较良恶性脊柱病变的葡萄糖标准摄取值SUV.结果 18F-FDG PET/CT和MRI对30例脊柱病变良恶性鉴别诊断的灵敏度、特异性、准确性、阳性预测值和阴性预测值分别为100％与84.6％(P ＞0.05)、94.1％与64.7％(P ＜0.05)、96.7％与73.3％(P ＜0.05)、92.8％与64.7％(P＞0.05)、100％与84.6％(P ＞0.05),18F-FDG PET/CT对脊柱病变良恶性鉴别诊断的特异性和准确性均优于MRI；恶性和良性病变椎体SUV分别为(3.8±0.6)与(1.5±0.8)(P＜0.05).结论 18F-FDG PET/CT显像对脊柱病变良恶性鉴别诊断有较高特异性和准确性,是对MRI有益的补充.

Diagnosis of benign and malignant diseases in spines:comparative study with 18F-FDG PET/CT and MRI

【Objective】 To analyze and compare the diagnostic efficacy for the discrimination of benign and malignant diseases in spines with 18F-FDG PET/CT and MRI.【Methods】 Thirty patients suspected of spine diseases were performed with 18F-FDG PET/CT and MRI,and the diagnostic sensitivity,specificity,accuracy,positive predictive values(PPV) and negative predictive values(NPV) for the discrimination of benign and malignant diseases in spines were respectively calculated and compared,and the SUVs in the corresponding vertebra were measured and compared.【Results】 The sensitivity,specificity,accuracy,PPV and NPV calculated for PET/CT and MRI were 100% and 84.6%(P >0.05),94.1% and 64.7%(P <0.05),96.7% and 73.3%(P <0.05),92.8% and 64.7%(P >0.05),100% and 84.6%(P >0.05),respectively.The diagnostic sensitivity and accuracy for the discrimination of benign and malignant diseases with PET/CT were superior to MRI.The SUVs in malignant and benign vertebra were(3.8±0.6) and(1.5±0.8)(P <0.05),respectively.【Conclusions】 18F-FDG PET/CT has a higher diagnostic specificity and accuracy for the discrimination of malignant and benign diseases in spines than MRI,which is a good supplementary for MRI in the differential diagnosis for spine diseases.