^99Tc^m—MDP全身及断层骨显像对颈椎病变的诊断价值

目的探讨^99Tc^m-亚甲基二膦酸盐（MDP）全身及断层骨显像对颈椎良恶性病变的诊断价值。方法回顾性分析随访资料完整且临床最终诊断明确的颈椎退行性变患者19例、转移瘤患者76例，以23名无颈椎及全身其他部位病变的健康者作为对照组，分析^99Tc^m—MDP全身骨显像及颈椎骨断层显像检查结果及图像特点，用，检验评价其诊断效能。结果颈椎断层显像对颈椎退行性变的诊断灵敏度（73．7％，14／19）明显高于全身骨显像（36．8％，7／19；χ^2=5．216，P〈0．05），颈椎断层显像诊断颈椎转移瘤的灵敏度和准确性分别为84．2％（64／76）和83．8％（83／99），明显高于全身骨显像56．6％（43／76）和61．6％（61／99），χ^2=13．9和12．3，P均〈0．01]。结论对临床怀疑颈椎病变的患者同时行全身骨显像及颈椎断层显像，可进一步提高颈椎病变的检出率，亦可为颈椎良恶性病变的鉴别提供更多的信息。

The clinical value of ~(99)Tc~m-MDP whole body imaging and SPECT in cervical vertebrae disease

Objective Cervical spine was one of the most important parts of the body.The aim of this study was to evaluate the clinical value of ~(99) Tc~m-methylene diphosphonate(MDP)whole body imaging and SPECT in detecting cervical vertebrae disease.Methods There were 95 patients including 19 with cervical vertebrae degeneration and 76 with cervical vertebrae metastasis.All patients and 23 normal con-trois underwent ~(99)Tc~m-MDP whole body imagin and cervical SPECT.The χ~2-test was used for data analysis.Results For detection of cervical vertebrae degeneration,the sensitivity of SPECT(73.7%,14/19)was significantly higher than that of ~(99)Tc~m-MDP whole body imaging(36.8%,7/19;χ~2=5.216,P<0.05).For the evaluation of cervical vertebrae metastases,the sensitivity and accuracy of cervical SPECT (84.2%,64/76;83.8%,83/99)were higher than those of ~(99)Tc~m-MDP whole body imaging(56.6%,43/76;61.6%,61/99;χ~2=13.9 and 12.3,all P<0.01).Conclusion Combined use of cervical SPECT and ~(99)Tc~m-MDP whole body imaging could improve the diagnostic value of cervical vertebrae disease.