SPECT／低剂量CT对全身骨显像肋骨病灶鉴别诊断的价值

目的探讨SPECT／低剂量CT对全身骨显像肋骨病灶鉴别诊断的应用价值。方法对99mTc—MDP全身骨显像无法确诊的42例肋骨病灶行SPECT／低剂量CT融合显像检查。由2位经验丰富的核医学科医师独立阅片进行诊断。最终诊断分别以病理学检查或其他影像学检查（诊断级CT或MRI）相印证或至少6个月的随访为依据。结果全身骨显像对肋骨病灶良、恶性诊断的灵敏度、特异性及准确性分别为82．61％、29．41％及60．00％；SPECT／CT融合图像的灵敏度、特异性及准确性分别为100％、88．24％及95．00％，SPECT／CT融合图像较全身骨显像能够显著提高肋骨病灶的特异性（χ2=12．14，P〈0．05）及准确性（χ2=14．05，P〈0．05）。结论sPEcT／低剂量CT融合图像可显著地提高肋骨病灶诊断的特异性及准确性；作为全身骨显像的有效补充，对肋骨病灶的鉴别诊断具有较高的应用价值。

Evaluating the Differentiating Diagnosis Value of SPECT/Low-dose CT Imaging Used in the Rib Lesions in the Whole Body Bone Imaging

Objective To evaluate the differentiating diagnosis value of SPECT/Low-dose CT fusion imaging used in the rib lesions in the whole body bone imaging.Methods 42 patients with malignant tumor and rib lesions undegoing the whole body bone imaging had been examined.All the rib lesions in the whole body bone imaging and SPECT/CT were analyzed. Based on the pathology examination,other imaging examination （CT or M RI） or follow-up results of more than 6 months,the sensitivity, specificity and accuracy of three imaging methods had been calculated.Results The sensitivity, specificity and accuracy of SPECT imaging were 82.61%,29.41% and 60.00% respectively, SPECT/CT was 100%, 88.24% and 95.00%, respectively. The specificity （χ2=12.14,P〈0.05） and accuracy （χ2 = 14.05,P〈0.05） of SPECT/CT were significantly higher than that of SPECT. Conclusion SPECT/Low-dose CT fusion imaging can significantly improve the sensitivity, specificity and accuracy of diagnosing the rib lesions in the whole body bone imaging. Therefore, it could be an effective supplement of the whole body bone imaging for its application value.