^(99m)Tc-MDP骨三相扫描诊断四肢单发骨肿瘤病灶  

Diagnosis of single limb bone tumor with ^(99m)Tc-MDP three-phase bone scintigraphy

作　　者：孙云钢[1] 冯会娟[1] 刘金华[1] 胡瑞[1] 欧阳伟[1] 

机构地区：[1]南方医科大学珠江医院核医学科,广东广州510282

出　　处：《中国医学影像技术》2012年第9期1719-1722,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的探讨99mTc-MDP骨三相扫描在诊断四肢单发骨肿瘤病灶中的价值。方法分析65例经手术病理证实的骨肿瘤患者的99mTc-MDP骨三相资料,比较良恶性骨肿瘤病灶的三相骨显像特征、血流动力学变化和骨代谢情况。结果在血流相,良性骨肿瘤的最高计数率、平均计数率、计数率-时间曲线斜率和曲线下面积均低于恶性骨肿瘤(t=-4.50、-3.93、-8.42、-3.03,P均<0.05),良性骨肿瘤计数率高峰时间晚于恶性骨肿瘤(t=8.03,P<0.05)。在血池相,良性骨肿瘤患/健侧ROI比值低于恶性骨肿瘤(t=-3.00,P<0.05),延迟相两者间差异无统计学意义(t=-1.99,P=0.08)。99mTc-MDP骨三相扫描诊断恶性骨肿瘤的灵敏度、特异度、准确率、阳性预测值和阴性预测值分别为89.47%(17/19)、86.96%(40/46)、87.69%(57/65)、73.91%(17/23)和95.24%(40/42)。结论 99mTc-MDP骨三相在反映良恶性骨肿瘤病灶血流灌注和骨代谢方面具有独特优势,血流灌注相及血池相对鉴别诊断良恶性四肢单发骨肿瘤具有一定临床意义。Objective To explore the value of 99mTc-MDP three-phase bone scintigraphy in diagnosis of single lesion of limb bone tumor. Methods 99mTc-MDP three-phase bone scintigrapby data of 65 patients with bone tumor confirmed with postoperative pathology were analyzed. The characteristics of three-phase bone imaging, changes of hemodynamics and bone metabolism were compared between benign and malignant bone tumors. Results In the blood flow phase, compared with malignant lesions, the highest count rate, the average count rate, count rate-time curve slope and area under the curve of benign lesions were significantly lower （t=-4.50, -3.93, -8.42, -3.03, P〈0.05）. The peak count rate time of benign lesions was later than that of malignant lesions （t=8.03, P〈0.05）. The difference of ROI ratio was significant between benign and malignant lesions in the blood pool phase （t=-3.00, P〈0.05）, while was not significant in the delay phase （t=- 1.99, P=0. 08）. The sensitivity, specificity, accuracy rate, positive predictive value and negative predictive value of 99mTc-MDP three-phase bone scintigraphy in diagnosis for malignant lesions was 89.47 % （17/19）, 86.96 G （40/ 46）, 87.69% （57/65）, 73.91% （17/23） and 95.24% （40/42）, respectively. Conclusion 99mTc-MDP three-phase bone scintigraphy has exclusive superiority in depicting blood flow and bone metabolism of benign and malignant bone tumors, thus is valuable for diagnosing single limb bone tumor.

关 键 词：骨肿瘤 放射性核素显像 诊断 鉴别 99m锝亚甲基二膦酸 

分 类 号：R738.1[医药卫生—肿瘤] R817.4[医药卫生—临床医学]