PET/CT和MRI诊断脊柱转移瘤的价值观察

目的观察PET/CT和MRI在脊柱转移瘤诊断中的应用价值。方法回顾性分析35例恶性肿瘤患者临床资料,患者均有MRI、18F-FDG PET/CT检查报告,且最终经病理学检查或随访证实,以病理学检查结果为标准,评价MRI、18F-FDG PET/CT检查诊断脊柱转移瘤的敏感度、特异度、准确度,比较两种检查方式阳性椎体检出率、单发椎体转移及成骨性骨转移瘤检出情况。结果 MRI诊断脊柱转移瘤的敏感度、特异度、准确度分别为0.750(18/24)、0.636(7/11)、0.714(25/35),PET/CT诊断脊柱转移瘤的敏感度、特异度、准确度分别为0.917(22/24)、0.727(8/11)、0.857(30/35);PET/CT转移椎体阳性检出率90.91%,显著高于MRI的67.05%(P<0.05);MRI检出的单发椎体转移病例,部分经PET/CT证实为多发病灶,经MRI检出成骨性骨转移瘤病例,部分在PET/CT显示为阴性。结论 PET/CT和MRI对脊柱转移瘤均有良好的诊断效能,且PET/CT较MRI能更好检出转移椎体病灶,但PET/CT对成骨性骨转移瘤检出不具优势。

Value of PET/CT and MRI in the Diagnosis of Spinal Metastases

Objective To observe the application value of PET/CT and MRI in the diagnosis of spinal metastases. Methods The clinical data of 35 patients with malignant tumors were retrospectively analyzed. All patients had examination reports of MRI and 18F-FDG PET/CT, and were finally confirmed by pathological examination or follow-up. The pathological examination results were used as criteria to evaluate the sensitivity, specificity and accuracy of MRI and 18F-FDG PET/CT in the diagnosis of spinal metastases. The detection rate of positive vertebral body and detection of single vertebral body metastasis and osteogenic bone metastases were compared between the two examination methods. Results The sensitivity, specificity and accuracy of MRI in the diagnosis of spinal metastases were 0.750(18/24), 0.636(7/11) and 0.714(25/35) respectively. The sensitivity, specificity and accuracy of PET/CT in the diagnosis of spinal metastases were 0.917(22/24), 0.727(8/11) and 0.857(30/35) respectively. The detection rate of positive metastatic vertebral body by PET/CT was significantly higher than that by MRI(90.91% vs 67.05%)(P<0.05). Some cases with single vertebral body metastasis detected by MRI were multiple lesions confirmed by PET/CT, and some cases with osteogenic bone metastases detected by MRI were negative shown in PET/CT. Conclusion PET/CT and MRI have good diagnostic efficacy on spinal metastases, and PET/CT can better detect metastatic vertebral lesions than MRI, but PET/CT has no advantage in detecting osteogenic bone metastases.