SPECT/CT同机融合显像对脊柱单发放射性“热区” 鉴别诊断的临床研究

目的：探讨99Tcm-亚甲基二膦酸盐（MDP）SPECT/CT融合显像对脊柱单发放射性浓聚影“热区”良恶性鉴别诊断的价值。方法：对131例常规99Tcm-MDP SPECT/CT全身骨显像时脊柱单发放射性“热区”同时行断层显像、CT图像以及后两者的同机融合图像。由2名核医学科医生共同阅片，作出最终诊断。结果：131例脊柱单发放射性“热区”，34例诊断为肿瘤骨转移，占总病例数的26.0%；94例诊断为良性病变，占总病例数的71.7%；3例诊断为原发骨肿瘤，占总病例数的2.3％。SPECT/CT同机融合显像不仅解决了常规骨显像对阳性病灶精确解剖定位难的问题，同时也显示脊柱单发病灶的良恶性与病灶的位置、形状密切相关。明显降低了骨显像诊断骨转移的假阳性率，对诊断骨转移的类型也有一定的价值。结论：SPECT/CT同机融合显像检查对脊柱单发放射性“热区”良恶性病变的鉴别诊断有重要的临床价值。

Clinical research of using SPECT/CT fusion imaging in differential diagnosis of single spinal 'hot spot' abnormality

Objective：To evaluate the value of ^99mTc-MDP SPECT/CT fusion imaging in differentiating malignant from benign single spinal radioactive ＇hot spot＇ abnormality.Methods：There were 131 patients underwent bone scan and SPECT/CT tomography.The diagnosis was made by two doctors from Nuclear Medicine Department.Results：Of the 131 lesions detected in whole body scan,34（26.0%） were malignant lesions and 94（71.7%） were benign lesions,3（2.3%） were primary bone tumors.SPECT/CT fusion imaging can supply the precise anatomical location of the conventional bone scan abnormalities.And show the associated location and shape in benign and malignant spinal lesions.It can significantly reduce the false-positive rate of bone scan in diagnosis of bone metastases;diagnosis of types of bone metastases as well.Conclusion：SPECT/CT fusion imaging has significant clinical value in differentiating malignant from benign single spinal radioactive ＇hot spot＇ abnormality.