SPECT/CT同机融合显像对肿瘤患者骨转移灶的诊断价值  

SPECT/CT fusion Imaging for the diagnosis of metastatic bone lesions in cancer patients

作　　者：王恩成[1] 徐莲[1] 孙晓光[1] 韩源[1] 

机构地区：[1]上海交通大学医学院附属仁济医院核医学科,上海200127

出　　处：《放射学实践》2011年第12期1323-1325,共3页Radiologic Practice

基　　金：上海重点学科建设项目(S30203)

摘　　要：目的:评价SPECT/CT同机融合显像对单独SPECT难于确诊良恶性的骨病灶的鉴别诊断价值。方法:SPECT骨扫描难于确诊的对53例肿瘤患者的84个病灶行局部SPECT/CT同机融合断层显像。所有患者转移灶确诊以临床病理、MRI、CT、骨扫描复查或PET/CT检查为依据。结果:①SPECT显像无法确诊的84个病灶,经SPECT/CT融合断层正确诊断的恶性病灶34个(40.5%),良性病灶44个(52.4%),仍无法确诊的5个(6.0%),误诊1个(1.2%)。②SPECT/CT融合显像对于单独SPECT难以确诊病灶的诊断符合率92.9%,对肿瘤骨转移的诊断灵敏度94.4%,特异度91.7%,阳性预测值89.5%,阴性预测值95.7%。结论:SPECT/CT同机融合显像能够对92.9%单独SPECT骨扫描难于确诊的病灶进行准确诊断,明显的提高了肿瘤骨转移病灶的诊断准确性,在肿瘤患者骨病灶的鉴别诊断中具有很高的临床应用价值。Objective：To evaluate the SPECT/CT fusion imaging in the diagnosis of benign and malignant bone lesions classified as indeterminate on SPECT alone of cancer patients.Methods：Eighty four bone lesions of 53 cancer patients,for whom the natures of the lesions were not able to be determined by the 99Tcm-MDP whole-body bone scan,were examined by the SPECT/CT fusion imaging simultaneously.All of the images were blindly interpreted independently by 2 physicians.In cases of discrepancy,consensus was obtained by a second joint reading.The natures of the lesions were eventually confirmed by pathology or other imaging examination or follow-up diagnosis six months later.Results：①Of 84 equivocal bone lesions on bone SPECT,34（40.5%） could be correlated with osteolysis and/or sclerotic metastases findings and 44（52.4%） could be correlated with benign findings on SPECT/CT accurately.Even after analysis of the SPECT/CT images,5 lesions（6.0%） remained indeterminate and 1 lesion was misdiagnosed.②The diagnostic accuracy of SPECT/CT for the 84 bone lesions was 92.9%,and the sensitivity,specificity,positive prediction value and negative prediction value were 94.4%,91.7%,89.5% and 95.7% respectively.Conclusion：SPECT/CT fusion imaging can effectively increase the diagnostic accuracy of metastatic bone lesions in tumor patients.

关 键 词：核医学 肿瘤转移 体层摄影术 X线计算机 图像融合 

分 类 号：R738[医药卫生—肿瘤]