SPECT／CT显像在肿瘤骨转移同一病灶动态随访中的价值  

Value of SPECT/CT imaging for follow-up of bone metastases

作　　者：董科[2] 石洪成[1] 刘江[2] 张一秋[1] 陈曙光[1] 蔡良[1] 

机构地区：[1]复旦大学附属中山医院核医学科,上海200032 [2]浙江省金华市中心医院影像科

出　　处：《中华核医学与分子影像杂志》2013年第3期199-202,共4页Chinese Journal of Nuclear Medicine and Molecular Imaging

摘　　要：目的探讨SPECT／CT显像在肿瘤骨转移同一病灶动态随访中的价值。方法回顾性分析178例行2次或2次以上全身骨显像（WBS）和SPECT／CT显像的肿瘤骨转移患者（总计387个骨转移病灶）的影像资料。由2位核医学科医师共同对随访病灶的WBS和SPECT／CT显像结果进行动态评判，结果均分为进展、好转或稳定；分析评判结果不一致的原因。临床随访（临床表现、肿瘤标志物、ALP、X线、CT、MRI等）结果也分为进展、好转或稳定。WBS和SPECT／CT显像随访结果差异的比较采用配对资料X^2检验。结果SPECT／CT显像随访结果结合临床表现，假设准确性为100％。在387个骨转移瘤病灶中，2种显像方法随访结果一致者313个，一致率为80．88％（313／387）；其中进展者208个，好转或稳定者105个，均与临床随访结果相符。不一致者74个，不一致率为19．12％（74／387）；其中WBS随访结果为好转或稳定、SPECT／CT为进展者48个，占64．86％（48／74）；WBS随访结果为进展、SPECT／CT为好转或稳定者26个，占35．14％（26／74）。WBS和SPECT／cT显像随访结果间的差异有统计学意义（X^2=6．54，P〈0．05）。结论在肿瘤骨转移同病灶的动态随访中，SPECT／CT显像较全身平面骨显像更有价值。Objective To retrospectively evaluate the value of SPECT/CT imaging for follow-up of bone metastases. Methods A total of 178 patients with bone metastases （387 lesions ） underwent 2 or more events of whole-body bone scintigraphy （WBS） and SPECT/CT imaging. Sequential images were analyzed by 2 experienced nuclear medicine physicians. Each lesion was interpreted as progressive, remissive or stable in WBS or SPECT/CT independently. Reasons for the discordance between WBS and SPECT/CT results were analyzed. The results of clinical follow-up, including clinical symptoms, tumor markers, serum ALP, radiograph, CT and MRI, were likewise classified as progressive, remissive or stable. Thex2 test was used to compare the differences between the two imaging methods. Results The fbllow-up results of the two imaging methods were consistent in 313 （80.88% , 313/387） lesions, including 208 in progression and 105 in remission or stable condition. Among the 74 （19.12% ,74/387 ） lesions showing discordance, 48 showed remission or stable conditions on WBS but progression on SPECT/CT （64.86% ,48/74） ; while 26 showed progression on WBS but remission or stable condition on SPECT/CT （35.14% , 26/74）. There was a sta- tistically significant difference of the follow-up results between WBS and SPECT/CT （X^2 = 6. 54, P 〈 0. 05 ）. Conclusion SPECT/CT is more valuable than WBS for follow-up of bone metastases.

关 键 词：肿瘤转移 骨骼 体层摄影术 发射型计算机 单光子 体层摄影术 X线计算机 MDP 

分 类 号：R730.44[医药卫生—肿瘤]