18F-FDG SPECT/CT与64排CT异机融合在结直肠癌诊断中的应用

目的 对比氟18-脱氧葡萄糖单光子发射计算机断层成像术（¹⁸F-FDG SPECT/CT）与GE 64排CT异机融合前后图像质量，探讨异机融合¹⁸F-FDG SPECT/CT（简称异机融合）诊断结直肠癌及TNM分期的优势。方法 36例经病理证实的结直肠癌患者接受¹⁸F-FDG SPECT/CT和异机64排CT检查，图像传输至后处理工作站，完成¹⁸F-FDG SPECT图像分别与同机低能量CT及异机64排CT图像融合。36例患者中，共65枚病灶，其中原发灶36枚，淋巴结转移灶19枚，远处转移灶10枚，并依此分为三组；分别对三组同机融合及异机融合图像中病灶边界是否清晰、与邻近脏器关系是否清晰、是否有伪影进行主观评分，同机融合及异机融合图像质量得分的比较采用Wilcoxon检验。结果 三组图像质量得分异机融合均高于同机融合，差异有统计学意义（z=-5.303和-3.858和-2.844，均P<0.01）。结论 结直肠癌原发灶、淋巴结转移灶、远处转移灶异机融合图像均优于同机融合图像，异机融合值得临床推广应用。

Application of cross-modality fusion images of 18F-FDG SPECT and GE 64 row CT in diagnosis of colorectal neoplasms

Objective To explore the advantages of cross-modality fusion images of ¹⁸F-fluorodeoxyglucose single photon emission computed tomography(¹⁸F-FDG SPECT/CT)and GE 64 row CT in diagnosis and TNM staging of colorectal neoplasms by comparing the images quality before and after fusion of both machines.Methods Thirty-six patients of colorectal neoplasms confirmed by pathology were examined by ¹⁸F-FDG SPECT/CT and hetero machine 64 row CT. The images were transferred to the post processing workstation, and ¹⁸F-FDG SPECT images were completed and fused with low energy CT and heterogeneous 64 row CT images by the same machine. 65 lesions from 36 patients, including 36 primary,19 metastatic lymph node and 10 distant metastasis were divided into 3 groups. The images processed by co-modality fusion and cross-modality fusion were scored respectively on clarity of mass boundary, clarity with adjacent organs and image artifacts. Wilcoxon test was used to compare the quality score of co-modality fusion with those of cross-modality fusion images.Results Score of cross-modality fusion images was higher than those of co-modality fusion images, which was statistically significant(z=-5.303 and -3.858 and -2.844,P<0.01).Conclusion Cross-modality fusion images of colorectal primary tumors, lymph nodes and distant metastasis are better than co-modality fusion images. Cross-modality fusion is worthy to be popularized in clinical practice.