SPECT／CT对脊柱病变鉴别诊断的价值

目的评价SPECT／CT显像在脊柱病变鉴别诊断中的应用价值。方法对53例^99Tc^m-MDP全身骨显像脊柱呈放射性浓聚患者进行SPECT／CT显像，获得SPECT、CT及两者的融合图像。所有病灶均以病理学诊断及6个月以上的影像学随访为最终诊断结果，计算SPECT／CT融合图像的诊断效能。结果SPECT／CT骨显像诊断骨转移肿瘤的灵敏度为96．00％（24／25），特异性为96．43％（27／28），准确性为96．23％（51／53），假阳性率为3．57％（1／28），假阴性率为4．00％（1／25），阳性预测值为96．00％（24／25），阴性预测值为96．43％（27／28）。对脊柱浓聚灶诊断非转移性骨病变的灵敏度为96．43％（27／28），特异性为96．00％（24／25），准确性为96．23％（51／53），假阳性率为4．00％（1／25），假阴性率为3．57％（1／28），阳性预测值为96．43％（27／28），阴性预测值为96．00％（24／25）。结论SPECT／CT同机融合显像结合了CT的解剖定位功能与^99Tc^m-MDP骨显像的高灵敏度，可提高诊断的特异性和准确性，有助于对脊柱病变的鉴别诊断。

Clinical value of SPECT/CT in differentiating spinal diseases

Objective To evaluate the value of SPECT/CT in differentiating malignancy from benign spinal disease. Methods Fifty-three patients with foci of abnormally increased uptake in the spine detected by 99Tcm-MDP planar whole body bone scan subsequently underwent bone SPECT/CT. The final diagnosis was determined by pathological examination or clinical follow-up ( ≥6 months), which was applied to calculate the diagnostic efficacy of bone SPECT/CT. Results A total of 25 patients were confirmed to have bone malignancy. The diagnostic sensitivity, specificity, accuracy, false positive rate, false negative rate, positive predictive value and negative predictive value for 99Tcm-MDP bone SPECT/CT were 96.00% (24/25), 96.43% (27/28), 96.23% (51/53), 3.57% ( 1/28), 4.00% ( 1/25), 96.00% (24/25) and 96.43% (27/28), respectively. Conclusion 99Tcm-MDP bone SPECT/CT imaging provides good clinical value for the differential diagnosis of spinal diseases.