SPECT/螺旋CT融合显像鉴别诊断颅骨良恶性病变的临床价值  

The value of single photon emission computed tomography/spiral computed tomography fusion imaging for the differential diagnosis of benign and malignant skull lesions

作　　者：韩鹏慧[1] 张书旭[2] 葛永兵[1] 任志刚[1] 张国前[1] 

机构地区：[1]广州医学院附属肿瘤医院,广东广州510095 [2]广州医学院附属肿瘤医院放疗中心,广东广州510095

出　　处：《中国临床医学影像杂志》2012年第7期484-487,共4页Journal of China Clinic Medical Imaging

摘　　要：目的:探讨SPECT/螺旋CT融合显像鉴别诊断颅骨良恶性病变的临床价值。方法:对19例恶性肿瘤患者全身骨扫描(WBS)显示颅骨放射性浓聚的21个病灶行SPECT/CT融合显像,由两名有经验的核医学科医生独立阅片。患者同期接受MRI和/或CT检查,各检查时间间隔不超过两周,并对所有病例进行随访,平均随访约9个月,随访结果主要根据随后的影像学检查(MRI、CT或随后的骨扫描)及临床信息。结果:根据同期影像及随访检查共10个病灶诊断为恶性病变,11个病灶诊断为良性病变。SPECT/CT融合显像检出全部10个恶性病灶及8个良性病变,诊断符合率为85.71%。1个病灶在SPECT/CT融合显像中诊断为恶性,而同期MRI及随访检查显示良性病变。另有两个病灶在SPECT/CT中难以确定其性质,同期影像及随访检查亦显示为良性。SPECT/CT融合显像在肯定性诊断为良、恶性病灶中诊断颅骨恶性病变的敏感性、特异性、阳性预测值、阴性预测值分别为100.00%、88.89%、90.91%、100.00%。结论:SPECT/螺旋CT融合显像对鉴别诊断颅骨良恶性病变有较高的敏感性和特异性。Objective： To evaluate the value of single photon emission computed tomography （SPECT）/spiral computed to- mography （CT） fusion imaging in the differential diagnosis of benign and malignant skull lesions. Methods： Nineteen cancer patients with 21 skull lesions on whole-body bone scan （WBS） were recruited and underwent SPECT/CT fused imaging of the head. The images were evaluated by two independent reviewers. The patients underwent MRI and/or CT examinations within two weeks after SPECT/CT. An average follow-up interval after SPECT/CT was 9 months to correlate with additional radiologic imaging studies and clinical informations. Results： Ten lesions were classified as metastatic lesions and 11 lesions were classi- fied as benign based on the other radiological examinations performed at the same period and follow-up. The SPECT/CT cor- rectly identified 10 out of 10 metastatic lesions and 8 out of 11 benign lesions, 85.71% of lesions were correctly classified. One lesion was classified incorrectly as metastatic lesion with SPECT/CT while it was proven benign by other imaging modali- ties and follow-up. Two lesions remained indeterminate even after the SPECT/CT examination and were confirmed benign by other imaging modalities and follow-up. The sensitivity, specificity, positive and negative predictive values of SPECT/CT images in the diagnosis of malignant skull lesions were 100.00%, 88.89%, 90.91% and 100.00%, respectively. Conclusions： SPECT/ spiral CT can help identify benign versus metastatic skull lesions with high sensitivity and specificity.

关 键 词：颅骨肿瘤 骨疾病 体层摄影术 螺旋计算机 体层摄影术 发射型计算机 单光子 

分 类 号：R738.1[医药卫生—肿瘤] R681[医药卫生—临床医学]