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作 者:韩丽君[1] 屈婉莹[1] 潘纪戍[2] 刘甫庚[2] 朱明[1] 张建飞[1]
机构地区:[1]卫生部北京医院PET中心,100730 [2]卫生部北京医院放射科,100730
出 处:《中华放射学杂志》2005年第11期1157-1161,共5页Chinese Journal of Radiology
摘 要:目的应用18氟-脱氧葡萄糖(18F-FDG)正电子发射计算机体层摄影(PET)-CT全身显像,探讨PET、同机CT和PET-CT融合图像在骨转移瘤诊断中的价值。方法共332例18F-FDG PET-CT受检者中有35例发现骨异常病变。分别阅读和记录18FDG PET图像、同机CT图像和PET-CT融合图像判断的良、恶性病变,比较3种方法在诊断骨转移瘤上的差异。结果35例中共检出89个病灶,其中68个病灶最后确诊为恶性肿瘤骨转移,21个为良性病变。PET诊断骨转移病灶62个,诊断良性病变17个,诊断骨转移瘤的敏感性为91.2%(62/68个),特异性为81.0%(17/21个),准确性为88.8%(79/89个);同机CT诊断骨转移病灶55个,良性病变16个。诊断骨转移瘤的敏感性、特异性和准确性分别为80.9%(55/68个),76.2%(16/21个)和79.8%(71/89个);PET-CT融合图像诊断骨转移病灶64个,良性病变19个,诊断骨转移瘤的敏感性、特异性和准确性分别为94.1%(64/68个),90.5%(19/21个)和93.2%(83/89个)。结论PET-CT融合图像在诊断骨转移瘤方面,可减少单用PET或单用CT诊断时的假阴性和假阳性,提高了鉴别骨良、恶性病变的能力。Objective To assess the value of 18-fluorodeoxy glucose (^18F-FDG) positron emission tomography ( PET )-CT in the detection of malignant bone metastases. Methods Thirty-five out of 332 patients, 89 lesions were detected on ^18F-FDG PET-CT and were interpreted separately on PET, combined CT, and fused PET-CT images. Results Of the 89 lesions detected on PET-CT images, 68 were malignant and 21 were benign lesions. PET alone identified 62 malignant lesions and 17 benign lesions. The diagnostic sensitivity, specificity, and accuracy of PET alone for diagnosis of bone metastases were 91.2% (62/68), 81.0% ( 17/21 ), and 88.8% (79/89), respectively. The combined CT alone identified 55 malignant lesions and 16 benign lesions. The diagnostic sensitivity, specificity, and accuracy of combined CT alone were 80.9% (55/68), 76.2% ( 16/21 ), and 79.8% (71/89), respectively. The fused PET-CT images identified 64 malignant and 19 benign lesions. The diagnostic sensitivity, specificity, and accuracy of the fused PET-CT were 94. 1% (64/68), 90.5% ( 19/21 ), and 93.2% (83/89), respectively. Conclusion In the diagnosis of bone metastases, ^18F-FDG PET-CT imaging reduces the false positive rate and increases the specificity. ^18F-FDG PET-CT imaging is helpful in the differentiation of bone metastases from benign lesions.
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