^18F-FDGPET／OT检测骨转移瘤的临床价值

目的评价B-2-^18F]-氟-2-脱氧葡萄糖（^18F-FDG）PET／CT显像在骨转移瘤中的诊断价值。方法回顾性分析118例被证实为恶性肿瘤骨转移患者的^18F-FDGPET／CT扫描情况，研究骨转移病灶形态学特征与代谢特征的关系及骨转移病灶代谢特征与原发肿瘤的关系，并比较了部分患者^18F-FDGPET／CT显像与^99mTc－亚甲基二膦酸盐（^99mTc—MDP）全身骨显像结果。结果溶骨性和混合性改变以显示高代谢病灶为主，它们分别与成骨性改变病灶及密度无改变病灶比较。差别均有统计学意义（P〈O．05）。^18F-FDGPET／CT显像和^99mTc—MDP全身骨显像诊断骨转移的灵敏度分别为90．4％，94．2％，特异性分别为98．8％，46．9％，准确性分别为92．9％，86．7％。^18F-FDGPET／CT显像诊断肿瘤骨转移的灵敏度与^99mTc—MDP全身骨显像无明显差别，但有更高的特异性和准确性。结论^18F-FDGPET／CT显像兼可反映骨转移灶不同的形态与代谢特征，较^99mTc-MDP全身骨显像有更高的特异性和准确性。对早期诊断多种肿瘤骨转移有重要价值。

Clinical Value of 18F-FDG PET/CT in Detection of Bone Metastases

Objective To evaluate the diagnostic value of ^18F-fluorodeoxyglucose（^18F-FDG）PET/CT imaging in detection of bone metastases. Methods The ^18F-FDG PET/CT scans of 118 patients with malignant bone metastases were studied retrospectively. The relationship between the morphological charac- teristics and metabolic characteristics, and between metabolic characteristics and primary tumor of bone metastases were observed. Parts of ^18F-FDG PET/CT scans and ^99mTc-methylenediphosphonate （^99mTc-MDP） bone scans were compared. Results Osteolytie and mixed lesions showed high metabolic lesions mainly. They all had significant differences when compared with osteoblastic lesions and normal bone density lesions respectively（P〈0.05）. The sensitivity, specificity and accuracy of ^18 F-FDG PET/ CT and ^99mTc-MDP bone scan in the diagnosis of bone metastases were 90. 4% vs 94. 2%, 98. 8% vs 46.9%, 92.9% vs 86.7%, respectively. The sensitivity was not significantly different between ^18F-FDG PET/CT and ^99mTc-MDP scintigraphy, but ^18F-FDG PET/CT had better specificity and accuracy. Gonclusions ^18F-FDG PET/CT can provide the different bone density changes as well as the metabolic characteristics of bone metastases, and has better specificity and accuracy than ^99mTc-MDP bone scintigraphy. It is of very important value in diagnosing various early bone metastases.