CT骨重建与SPECT异机融合显像在骨转移瘤诊断的应用价值

目的 CT骨重建与SPECT异机融合显像在骨转移瘤诊断的应用价值。方法选择150例192处不典型病灶加做SPECT及同部位的CT检查,然后利用异机融合软件进行图像融合,参考融合图像和CT检查分别对不典型病灶进行转移瘤、良性病灶以及不确定可疑病灶的诊断。最后对29例病灶进行良恶性的随访,分别计算CT骨重建和SPECT与CT的融合图像的灵敏度、特异性、准确率(符合率)、假阳性率、假阴性(漏诊)率、阳性结果预测值、阴性结果预测值。结果 150例共检出192处病灶,其中异机融合显像检出良性病灶74个,恶性病灶89个,最终有29个可疑病灶未能明确诊断;单纯CT骨重建明确良性病灶41个,恶性病灶48个,有103个未能明确诊断或者无阳性改变。两者相比较,差异有统计学意义(P<0.01)。对29例已确诊的病例进行随访,异机融合图像的灵敏度、特异度、准确率分别是93.3%、85.7%、89.7%;而单纯CT骨重建为84.6%、68.8%、75.9%。结论 CT骨重建与SPECT异机融合显像在骨转移瘤的诊断中具有较高的鉴别和定性价值,且具有定位精确、早期诊断,指导治疗计划和增强诊断信心等优点,使得其临床应用价值大大提高了。

The diagnosis value of fused single-photon emission computed tomograghy and computed tomograghic images in bone metastases

Objective The aim of this study was to evaluate the diagnosis value of fused single-photon emission computed tomograghy and computed tomograghic images in bone metastases.Methods 150patients were chosed,and 192lesions were detected on 99m Tc-MDP whole body bone imaging and were interpreted separately on fused SPECT-CT images and single CT reconstruction images.29patients were followed up or received additional examination.The differences of the diagnosis of SPECT-CT fused images and CT images were analyzed.Results 192lesions detected on fused images,74were malignant and 89were benign lesions,only 29were suspensed ;fused images had significant differences with single CT(P<0.01).29patients with definite diagnosed,the diagnostic sensitivity,specificity,accuracy rate,of fused SPECT and CT images were 93.3%,85.7%,89.7%,while single CT images were 84.6%,68.8%,75.9%,respectively.Conclusion SPECT and CT image fusion analysis has high value in differentiation of bone metastasis from benign lesions ;enhance the confidence of images diagnosis and greatly improve the value of clinic application.