放射性核素骨SPECT/CT同机融合显像诊断SPECT难于确诊骨病灶

目的 评价SPECT/CT同机融合显像对SPECT难于确诊骨病灶的诊断价值.方法 对SPECT难于确诊的35例肿瘤患者的37个病灶行SPECT/CT同机融合显像.由2名经过放射学培训的核医学科医师盲法独立阅片.所有病灶均以病理、磁共振结果 或6个月以上的随诊为最终诊断结果 .结果 SPECT CT和SPECT/CT分别可对17个(17/37,45.95%)和30个(30/37,81.08%)病灶做出准确诊断,SPECT/CT诊断的正确率较SPECT明显提高(X2=9.855,P=0.002).SPECT、SPECT CT和SPECT/CT诊断为性质待定的病灶,经随访确诊后恶性病灶所占比率分别为29.7%(11/37)、26.3%(5/19)和16.7%(1/6).结论 SPECT/CT同机融合显像有助于鉴别诊断SPECT难于确诊骨病灶的性质,应作为SPECT显像的重要补充.

SPECT/CT fusion imaging in evaluation of foci bone metabolisms classified as indeterminate on SPECT

Objective To evaluate radionuclide bone SPECT/CT fusion imaging in the assessment of foci bone metabolism classified as indeterminate on SPECT.Methods A total of 37 lesions in 35 patients without concrete diagnosis on SPECT underwent radionuclide bone SPECT/CT imaging.The final diagnosis of these patients were obtained with MRI,pathology or follow-up for more than six months.Results Among 37 equivocal lesions on bone SPECT,the diagnostic accuracy was 45.95%(17/37)for SPECT CT and 81.08%(30/37)for SPECT/CT,respectively(x~2=9.855,P=0.002).Of the e- quivocal lesions by SPECT,SPECT CT and SPECT/CT,the ratio of malignancy was 29.7%(11/37),26.3%(5/19)and 16.7%(1/6),respectively.Conclusion Radionuclide bone SPECT/CT fusion imaging is of great importance in the assess- ment of foci bone metabolism classified as indeterminate on bone SPECT,and should be used as a valuable supplementary procedure to bone SPECT.