18F-FDG PET/CT与99Tcm-MDP骨显像在恶性肿瘤骨转移中的检查效能比较

目的:比较18F-FDG PET/CT与99Tcm-MDP骨显像对肿瘤骨转移灶的检出率，探讨两种方法在骨转移灶筛查中的价值。 方法:137例确诊恶性肿瘤患者在1月内分别进行99Tcm-MDP骨显像及18F-FDG PET/CT显像，比较分析两者对骨转移灶检出率的结果。结果:137例患者之中66例患者99Tcm-MDP骨显像为阳性，中轴骨、四肢骨均可出现，检出率为48.2%（66/137）； 71例骨显像阴性患者中有12例PET/CT结果为阳性。所有患者之中62例患者18F-FDG PET/CT为阳性，检出率为45.3%（62/137）,75例PET/CT阴性患者中有16例骨扫描结果为阳性。两种方法检出率之间比较（P=0.068），差异无统计学意义；按四种骨质改变类型比较两种方法检出率（P=0.173），差异无统计学意义；按CT溶骨性与成骨性类型分类比较两种方法（P=0.018），两者差异有显著性意义。结论:18F-FDG PET/CT与99Tcm-MDP骨显像筛查恶性肿瘤骨转移灶效能无明显差别，18F-FDG PET/CT优势在于发现溶骨性病变，而99Tcm-MDP骨显像的优势为成骨性改变。

The comparative study of 18F-FDG PET/CT and 99Tcm-MDP bone scintigraphy in detecting bone metastasis

Objective:To compare the diagnostic performance of F-2-deoxyglucose(18F-FDG) PET/CT imaging and 99Tcm-MDP bone scintigraphy in detecting bone metastasis.Methods:18F-FDG PET/CT and 99Tcm-MDP bone scintigraphy were performed in 137 malignant tumor patients confirmed by pathology within one months.The sensitivity,specificity and accuracy were compared.Results:48.2%（66/137）were positive in 99Tcm-MDP bone scan,and in 71 patients with 99Tcm-MDP negative 12 cases showed positive diagnosis with 18F-FDG PET/CT.45.3%（62/137）were positive in 18F-FDG PET/CT imaging,and in 75 patients with 18F-FDG PET/CT negative 16 cases showed positive diagnosis with 99Tcm-MDP.There was no significance difference in detecting bone metastasis.The incidence in four types of bone change showed no significant statistical difference(P=0.173) and osteolytic metastasis vs osteoblastic showed significant statistical difference(P=0.018) according to CT features.Conclusion:There was no difference in detecting bone metastasis between 18F-FDG PET/CT and 99Tcm-MDP scan.However,18F-FDG PET/CT was better for osteolytic and 99Tcm-MDP was better for osteoblastic lesions.