99mTc-MDP SPECT/CT同机图像融合在骨转移肿瘤诊断中的应用

目的探讨^99mTc—MDP SPECT／CT同机图像融合在骨转移肿瘤显像中的诊断价值。方法对250例可疑转移性骨病变和不明原因骨痛的患者使用^99mTc—MDP SPECT全身骨显像扣SPECT／CT同机图像融合，结合病史、临床表现和病理检查进行回顾分析。结果250例患者SPECT全身骨显像骨骼系统可见1368处异常放射性浓聚点。经过SPECT／CT同机图像融合发现：其中17处为放射性污染造成的假阳性病灶，235处为骨质增生性病变，1116处为骨转移肿瘤导致的骨质破坏，全身骨显像SPECT假阳性率为18．4％（252／1368）．与病史和病理检查结果相符。结论^99mTc—MDPSPECT／CT图像同机融合与平面骨显像SPECT比较，可对骨转移肿瘤提供准确的骨损伤解剖部位．在骨转移肿瘤的临床诊断中具有重要价值。特别是平面骨显像可疑的患者都应该使用SPECT／CT图像同机融合。

Fusion images of SPECT/CT in diagnosis of bone metastases

Objective To evaluate the clinical value of 99mTc-methylene diphosphonic acid(MDP)SPECT/CT imaging in diagnosis of bone metastases.Methods Two hundred and fifty cases with malignant tumors or unknown bony pain underwent whole body and local bone imaging with ~(99m)Tc-MDP SPECT and SPECT/CT.Related history,clinical manifestation and pathology,SPECT and SPECT/CT fusion imaging were retrospectively analyzed.Results The foci of increased activity were 1368 in 250 cases analyzed by SPECT.However,17 of total 1368 analyzed by SPECT/CT related to the contamination of ~(99m)Tc-MDP,235 related to the hyperosteogeny,1116 related to the bone lesions of the bone metastases.False positive rate of the SPECT was 18.4%,1116 of the foci of increased activity accorded with his- tory and clinical manifestation.Conclusion ~(99m)Tc-MDP SPECT/CT could provide precise anatomical localization of focal lesions,fusion images of ~(99m)Tc-MDP SPECT/CT has an important value in diagnosis of bone metastases.Therefore,SPECT/CT should be applied when- ever equivocal findings of plane bone imaging occur.