SPECT与低剂量CT融合显像在颅骨病变良恶性鉴别诊断中的价值

为评价SPECT与低剂量CT融合显像在鉴别颅骨良、恶性病变中的临床应用价值,选取伴颅骨病变的骨外原发肿瘤患者81例（118个病灶）,所有患者均行全身平面骨显像,其中25例（40个病灶）行颅骨SPECT显像,43例（66个病灶）行头部异机CT或MR I显像,12例（19个病灶）行颅骨SPECT与低剂量CT融合显像。所有图像均由至少两名医师判读,判读结果与最后诊断符合者,为＂符合＂。计算并比较各种方法在鉴别颅骨病变中的符合率。各种方法在良/恶性病灶诊断符合率及总符合率上均有显著性差异,其中SPECT与低剂量CT融合显像的总符合率优于其他方法。在判定良性病灶时,SPECT与低剂量CT融合显像与其他方法之间均有显著性差异,符合率优于其他方法;在判定恶性病灶时,SPECT与低剂量CT融合显像与全身骨显像、骨SPECT显像存在显著性差异,符合率优于二者。SPECT与低剂量CT融合骨显像在鉴别诊断颅骨良恶性病变中具有较好的临床应用价值。

Evaluation of SPECT Combined with Low Dose CT Fusion Imaging for Differential Diagnosis of Benign and Malignant Skull Diseases

To evaluate the value of the fusion imaging obtained from SPECT combined with low dose CT for differential diagnosis of benign and malignant skull diseases, 81 patients with skull diseases （total in 118 focal spots without pathological proved） underwent bone scanning using 99mTc-methylene diphosphonate （MDP）,25 of them （dO focal spots） underwent SPECT, 43 of them （66 focal spots） underwent CT or MRI, and 12 of them （19 focal spots） underwent SPECT combined with low dose CT in addition. The diagnostic accuracy of benign and malignant diseases was evaluated by four modalities. The results showed that there are markedly statistical differences in the diagnostic accuracy of four modalities. In the diagnosis of benign and malignant diseases, the diagnostic accuracy of SPECT/CT fusion imaging was much better than those of other modalities. The fusion imaging of SPECT/CT may be clinically valuable in differential diagnosis of benign and malignant skull diseases.