骨显像定量分析对骨组织单发性病灶良恶性鉴别诊断

目的 :探讨延迟局部骨显像定量分析 ,即TF比值的测定对骨单发性病灶良恶性鉴别诊断的临床意义。方法 :共 45例病人 ,分为 3组 ,即多发性骨转移癌组 (A组 ,12例 )、单发性病灶恶变组 (B组 ,15例 )和单发性病灶良性组 (C组 ,18例 )。在常规的全身骨显像基础上进行早期 (3～ 4h)和延迟 (2 4h)的局部静态骨显像 ,然后求出病灶区 (L)和正常区 (N)的放射性计数。结果 :①A组、B组和C组的TF比值分别为 :1 488± 0 .338、1 384± 0 .2 2 3和1.174± 0 .2 11;A组与B组的TF比值差异不显著 (P >0 .0 5 ) ,C组的TF比值比A组及B组皆要低 ,且差异显著(P <0 .0 1)。②若以A组TF比值的 x -s即 1.15作为骨单发病灶恶变的诊断阈值 ,则其灵敏度、特异性和准确率分别是 93.3%、72 .2 %和 81.8%。结论 :延迟局部骨显像定量分析 (TF比值的测定 )对骨单发性病灶良恶性的鉴别诊断有较大的临床应用价值。

Bone Imaging Quantitative Analysis in the Differential Diagnosis of Benign and Malignant Bone Single Lesion

To investigate the clinical significance of bone quantitative imaging(TF ratio measurement) in the differential diagnosis of benign and malignant bone single lesion. Methods:45 patients were divided into three groups:bone metastases (group A, 12 patients), malignant bone single lesion (group B,15 patients) and benign bone single lesion (Group C,18 patients). Early (3 to 4hours) and delayed(24hours ) local static bone imaging were conducted after the rountine whole body bone scan which was performed three hours after the intravenous injection of 99Tmc-MDP.Then the radioactivities in the lesion areas and non-lesion areas were determined and TF ratios were calculated. Results: (1) The TF ratio of group A, B and C was 1.488±0.338,1.384±0.223 and 1.174±0.211 respectively.No significant difference was found in the TF ratio between group A and B(P>0.05), whereas the TF ratio of group C was significantly lower than that both of group A and B(P<0.01). (2) When 1.15 was used as the diagnostic threshold, the sensitivity,specifity and accuracy were 93.3%,72.2% and 81.8% respectively. Conclusions: Bone imaging quantitive analysis(TF ratio measurement) may be a liable technique in the differential diagnosis of the bone single lesion.