99Tcm-MIBI显像在骨单发灶鉴别诊断中的应用价值

目的探讨99 Tcm-MIBI显像在骨单发灶鉴别诊断中的应用价值并与99 Tcm-MDP骨显像进行比较。方法 105例骨单发灶患者,经金标准(病理或其它综合影像诊断)证实的恶性肿瘤70例,良性病变35例,均分别行99 Tcm-MDP并SPECT/CT融合及99 Tcm-MIBI检查,进行视觉读片和半定量分析,结果与金标准诊断结果进行对照并行统计学处理,用ROC曲线评价99 Tcm-MDP平面并融合显像及99 Tcm-MIBI显像对骨单发灶的诊断效能。结果 99 Tcm-MDP及99 Tcm-MIBI显像灵敏度分别为94.29%和87.14%(P<0.05),特异度分别为80.00%和82.86%(P<0.05)。99 Tcm-MDP骨显像中良恶性病灶的T/N值差异无统计学意义(P>0.05)。99 Tcm-MIBI早、晚期显像中恶性病灶的T/N值分别为(2.45±0.79)、(2.96±0.89),均明显高于良性病灶的早、晚期显像的T/N值[(1.30±0.34)、(1.39±0.38)],差异均有统计学意义(P<0.05)。ROC曲线下面积依次是:99 Tcm-MIBI晚期>99 Tcm-MIBI早期相>99 Tcm-MIBI滞留指数(RI)>99 Tcm-MDP。结论 99 Tcm-MIBI显像较99 Tcm-MDP平面并融合显像灵敏度低、特异性高,在骨单发灶的诊断中有较好的诊断效能。

The value of 99Tcm-MIBI imaging in differential diagnosis in single malignant and benign bone lesion

Objective To investigate the value of the 99Tcm-MIBI double phase imaging in differential diagnosis in single malignant and benign bone lesion of skeleton and to compare with the result of 99Tcm-MDP imaging.Methods One hundred and five patients including 70 malignant cases and 35 benign cases were studied with both 99Tcm-MDP imaging and 99Tcm-MIBI double phase imaging,visual reading of films and semi-quantitative analysis were taken,the results were compared with the gold standard ROC curve was uesd to evaluate the diagnostic ability of 99Tcm-MDP and 99Tcm-MIBI,for single malignant and benign bone lesion.Results With 105 cases of single skeleton lesions imaging of 99Tcm-MDP sensitivity(94.29%) was higher than 99Tcm-MIBI double phase imaging(87.14%),the specificity of 99Tcm-MIBI imaging(82.86%) was higher than that of 99Tcm-MIBI double phase imaging(80.00%).In quantitative analysis of 99Tcm-MIBI early and delay scan,the mean T/N ratio of malignant lesions were(2.45±0.79),(2.96±0.89),which were significantly higher than that of benign counterparts [(1.30±0.34,1.39±0.38,0.11±0.33,P<0.05)].Area under the ROC curve was followed by: 99Tcm-MIBI late phase >99Tcm-MIBI early phase >99Tcm-MIBI in the retention index(RI)>99Tcm-MDP.Conclusion Compared with 99Tcm-MDP,99Tcm-MIBI had the features of low sensitivity,high specificity,good diagnostic performance in single bone tumor diagnosis.