MIBI及MDP显像在骨单发病灶诊断中价值

目的探讨99mTc-MIBI显像在骨单发病灶鉴别诊断中价值并与99mTc-MDP骨显像进行比较。方法对105例骨单发病灶患者(恶性肿瘤70例,良性病变35例)均进行99mTc-MDP并SPECT/CT融合及99mTc-MIBI检查,用ROC曲线评价99mTc-MDP平面并融合显像及99mTc-MIBI显像对骨单发病灶的诊断效能。结果 99mTc-MDP及99mTc-MIBI显像灵敏度分别为94.29%和87.14%(P<0.05),特异度分别为80.00%和82.86%(P<0.05);99mTc-MDP骨显像中良、恶性病灶的T/N(放射性计数比)值差异无统计学意义(P>0.05);99mTc-MIBI早、晚期显像中T/N值恶性病灶分别为(2.45±0.79)和(2.96±0.89),均明显高于良性病灶(1.30±0.34)和(1.39±0.38)(P均<0.05);AUC依次为99mTc-MIBI晚期>99mTc-MIBI早期>99mTc-MIBI滞留指数>99mTc-MDP。结论 99mTc-MIBI显像较99mTc-MDP平面并融合显像灵敏度低、特异性高,对骨单发病灶有较好诊断效能。

Value of 99mTc-MIBI and 99mTc-MDP imaging to the diagnosis of single bone lesion

Objective To investigate the clinical value of the 99mTc-MIBI double phase imaging to differential diagnosis of single bone lesion and to compare with the result of 99mTc-MDP imaging.Methods A total of 105 patients(70 malignant and 35 benign) received both 99mTc-MDP imaging and 99mTc-MIBI double phase imaging.The diagnostic value of 99mTc-MDP imaging and 99mTc-MIBI double phase imaging was evaluated with ROC curve.Results The sensitivity of 99mTc-MDP and 99mTc-MIBI was 94.29% and 87.14%,respectively(P<0.05),and the specificity of 99mTc-MIBI and 99mTc-MIBI was 82.86% and 80.00%,respectively(P<0.05).There was no significant difference in T/N ratio between malignant and benign lesion in the quantitative analysis of 99mTc-MDP scan(P>0.05).In quantitative analysis of 99mTc-MIBI early and delay scan,the mean T/N ratio of malignant lesions(2.45±0.79,2.96±0.89) was significantly higher than that of benign lesion(1.30±0.34,1.39±0.38)(P<0.05).The area under ROC curve was from big to small in the order of 99mTc-MIBI delay imaging,99mTc-MIBI earlyscan,99mTc-MIBI RI and to 99mTc-MDP.Conclusion 99mTc-MIBI imaging is better than 99mTc-MDP to diagnose single bone lesion,with low sensitivity and high specificity.