探讨SPECT/CT图像融合对骨转移瘤的增益价值

目的 探讨SPECT/CT图像融合技术在诊断骨转移瘤中的应用价值.方法 回顾性分析2010年1月～2013年1月在我院核医学科进行肺癌术前查体的患者资料,其中376例为全身骨显像（whole-body bone scintigraphy,WBBS）,172例为局部SPECT/CT（single photon emission computed tomography-computed tomography）融合图像检查,对两种检查能够提供有效诊断的比例进行统计学比较.以临床诊断或随访结果为最终判定标准,对两组显像方式的灵敏度、特异度、阳性预测值、阴性预测值、准确度进行比较.结果 SPECT/CT的诊断效能明显高于WBBS（Z=2.769,P =0.006）.SPECT/CT显像的灵敏度为94.4％、特异度为89.0％、阳性预测值为86.1％、阴性预测值为95.7％、准确度为91.5％,明显高于SPECT的82.4％（χ^2 =4.281,P=0.039）、80.1％（χ^2=4.085,P=0.043）、54.7％（χ^2=21.658,P =0.000）、94.0％（χ^2 =0.392,P=0.531）、80.6％（χ^2=10.012,P=0.002）.结论 SPECT/CT图像融合较WBBS能够提高骨转移瘤患者的诊断符合率,能够为临床医生提供更多有价值的诊断信息.

The applied value of SPECT/CT fusion imaging in patients with bone metastasis

Objective To investigate SPECT/CT image fusion technique in the diagnosis of bone metastases. Methods A retrospective study was performed on 548 lung cancer patients before surgery form January 2010 to January 2013, in which 376 cases accepted whole-body bone scintigraphy （WBBS） and the remaining 172 accepted SPECT/CT imaging. The histopathological evaluation, clinical diagnosis and follow-up results served as the final criteria. The effective ratio provided by the two methods were compared statistically. Beyond that, we contrasted the diagnostic efficiency of the two imaging methods including sensitivity, specificity, positive predictive value, negative predictive value and accuracy. Results The diagnostic efficiency of SPECT/CT was significantly higher than WBBS （Z= 2.769, P=0.006）. The sensitivity （94.4%）, specificity （89.0%）, positive predictive value （86.1%）, negative predictive value （95.7%）, and accuracy （91.5%） of SPECT/CT imaging was significantly higher than that of WBBS 82.4% （χ^2 =4. 281, P=0. 039）, 80.1% （χ^2 =4.085, P =0.043）, 54.7% （χ^2 =21.658, P =0.000）, 94.0% （χ^2 =0.392, P =0.531）, 80.6% （χ^2 =10.012, P =0.002）. Conclusion SPECT/CT image fusion can not only improve the diagnosis compliance rates of bone metastases patients but also provide more valuable diagnostic information to clinical practice.