^18F-FDG显像诊断骨转移瘤价值与骨显像的比较

目的:本文旨在评价18F-FDG符合线路显像与99mTc-MDP全身骨显像对骨转移瘤的诊断价值,探讨两种显像结果的差异及可能的原因。方法:对41例因怀疑恶性肿瘤或有骨转移病人在4周内同期行18F-FDG显像和99mTc-MDP全身骨显像,并对两种检查结果进行比较。结果:39例恶性肿瘤,确诊骨转移瘤19例,11例良性骨病变,9例正常,2例良性肿瘤。18F-FDG符合线路显像对骨转移瘤诊断的灵敏度、特异度、阳性预测值、阴性预测值和准确率分别为94.7%、85.0%、87.1%、93.7%和89.7%,而99mTc-MDP全身骨显像分别为84.2%、55.0%、65.3%、76.5%和69.2%,两组仅准确率(P<0.05)的差异存在统计学上的意义。结论:两种显像在判断恶性肿瘤骨转移方面的效果基本相同,都是比较理想的检查方法。但18F-FDG显像对骨转移瘤诊断的准确率高于骨显像。

Comparison between 18F-FDG Imaging and 99mTc-MDP Bone Scan to Detect Bone Metastases

Objective To assess the diagnostic value of 18F-FDG imaging and 99mTc- MDP whole-body bone scan to detect bone metastases by comparing the difference between them and searching for the probable reasons. Methods The study group comprised 41 patients suspected with malignant tumor or bone metastasis undergoing both 18F-FDG imaging and 99mTc- MDP whole-body bone scan. The interval of the two examinations was less than 4 weeks. Results 39 of 41 patients were established to have primary tumors and the other 2 were benign bone disease. In 39 patients with primary tumors, 19 patients were established as bone metastases, 11 were benign bone lesions, 9 were normal. The diagnostic sensitivity, the specificity, the positive predictive value, the negative predictive value and the accuracy in detecting bone metastasis by 18F-FDG were94.7%, 85.0%, 87.1%, 93.7%, 89.7%, respectively. Correspondingly,by 99mTc- MDP whole-body bone scan were 84.2%,55.0%,65.3%,76.5%,69.2%.The diagnostic accuracy of 18F-FDG imaging in detecting bone metastases were greater significantly than that of 99mTc- MDP whole-body bone scan, and the specificity, sensitivity, positive predictive and false predictive values of them were not different significantly. Conclusion Both 18F-FDG imaging and 99mTc- MDP whole-body bone scan were ideal methods to evaluate the metastatic bone lesions. The diagnostic accuracy of 18F-FDG imaging in detecting bone metastases was greater significantly than that of 99mTc- MDP whole-body bone scan.