SPECT/CT骨显像在肿瘤患者可疑脊柱转移灶中的诊断价值

目的 评价99Tcm-亚甲基二膦酸盐(MDP)SPECT/CT骨显像对肿瘤患者可疑脊柱转移灶的诊断价值.方法 选取76例99Tcm-MDP骨显像可疑脊柱转移灶患者,进行SPECT/CT同机融合显像.76例患者中,与病理(含术中病理)检查结果对照19例,与随访1年余(2006年6月至2006年12月患者,随访至2008年3月)结果对照14例,显像结果与CT及MRI的共同结果对照43例.结果 SPECT/CT显像诊断肿瘤脊柱转移灶的灵敏度为95.83%(23/24),特异性为90.38%(47/52),准确性为92.11%(70/76),阳性预测值为82.14%(23/28),阴性预测值为97.92%(47/48),阳性似然比为9.97,阴性似然比为0.05.结论 SPECT/CT提高了肿瘤可疑脊柱转移灶鉴别诊断的准确性和特异性.

The diagnostic value of SPECT/CT 99Tcm-MDP imaging in suspected bone metastasis

Objective The aim of this study was to evaluate the value of SPECT/CT in detecting spine metastases using 99Tcm-methylene diphosphonic acid(MDP).Methods A total of 76 patients with suspicious spine metastases underwent SPECT/CT 99Tcm-MDP imaging.Of these 76 patients,19 were confirmed by histopathology,14 were endorsed by clinical follow up,and 43 were by CT and MRI.Results Of these 76 patients,28 were spine metastases and 48 were benign degenerative changes with SPECT/CT.Sensitivity of diagnosis of the metastatic bone tumor with SPECT/CT 99Tcm-MDP imaging in lesion of dorsal spine Was 95.83%(23/24),specificity Was 90.38%(47/52),accuracy Was 92.11%(70/76),positive predictive value was 82.14%(23/28),negative predictive value was 97.92%(47/48),positive likelihood ratio was 9.97,negative likelihood ratio was 0.05.Conclusions The diagnostic CT of SPECT/CT had adding value in providing detail anatomical information to SPECT in patients with suspicion bone metastasis.Such help may improve the diagnostic accuracy in differentiating benign from malignant lesion at spine.