SPECT/CT融合显像对肺癌单发骨转移瘤的诊断价值  

SPECT/CT fusion imaging for differential diagnosis of bone solitary metastases in patients with lung cancer

作　　者：常城[1] 谢文晖[1] 雷贝[1] 刘慈懿[1] 冯键[2] 

机构地区：[1]上海交通大学附属胸科医院核医学科,上海200030 [2]上海交通大学附属胸科医院胸外科,上海200030

出　　处：《核技术》2013年第9期50-55,共6页Nuclear Techniques

基　　金：上海市胸科医院科技发展基金(YZ13-21);上海市核医学会青年骨干提升计划经费项目(2009-NM-11);上海市卫生局(2010066);上海市科委(11ZR1433700)资助

摘　　要：评价SPECT/CT同机融合图像在肺癌单发骨转移瘤定性诊断中的价值。选择196例全身骨显像表现为单发异常放射性核素分布的肺癌患者行骨病变部位CT扫描。由2名核医学科医师对全身骨扫描、SPECT/CT同机融合图像分别做出诊断,诊断分为肺癌骨转移、良性病变,诊断结果分别于最终诊断比较。196例患者,最终诊断骨转移瘤112例,全身骨显像检出89例,SPECT/CT融合显像检出106例。SPECT/CT融合显像探测骨转移瘤的敏感性、特异性及准确性分别为94.6%(106/112)、92.9%(78/84)、93.9%(184/196),明显高于全身骨显像的敏感性79.5%(89/112),特异性78.6%(78/84)、准确性79.1%(155/196)(χ2=11.25,P<0.05;χ2=7.00,P<0.05;χ2=18.35,P<0.05)。在对肺癌单发骨病灶是否为转移的鉴别诊断方面,SPECT/CT融合显像可以提供更多的信息,可以明显提高肺癌单发骨转移瘤的诊断准确率。Background： Making an accurate diagnosis of bone metastasis earlier is very important for lung cancer clinical stage and making treatment plans. SPECT/CT fusion imaging provides more information than SPECT in diagnosing bone metastases from benign lesions of the solitary abnormal radioactive nuclide distribution in patients with lung cancer. Purpose： We want to investigate the value of SPECT/CT fusion imaging in identifying solitary bone metastases in patients with lung cancer. Methods： 196 patients with lung cancer, whose bone scintigraphy demonstrated solitary abnormal radioactive nuclide distribution, were selected. SPECT/CT was employed for those lesions. SPECT and SPECT/CT bone images were analyzed by two seasoned nuclear medicine physicians separately. Each lesion was diagnosed with metastasis and benign lesion. The diagnosed results were compared with the final diagnosis. Results： 196 patients with lung cancer had 196 lesions, 112 bone metastatic lesions were proved to be bone metastatic criterion, 89 metastatic lesions were found by SPECT, and 106 metastatic lesions were found by SPECT/CT. The sensitivity, specificity and accuracy of SPECT/CT and SPECT in the diagnosis of bone metastasis were 94.6%（106/112）, 92.9%（78/84）, 93.9%（184/196）; 79.5%（89/112）, 78.6%（78/84） and 79.1%（155/196）, respectively. The sensitivity, specificity and accuracy of SPECT/CT were higher than those of SPECT （Х^2=11.25, P〈0.05; Х^2=7.00, P〈0.05; Х^2=18.35,/~〈0.05）. Conclusions： SPECT/CT fusion imaging provided more information than SPECT imaging in distinguishing metastases from benign lesions of the solitary abnormal radioactive nuclide distribution in patients with lung cancer and improved the accuracy of the diagnosis of solitary bone metastasis of lung cancer.

关 键 词：肺肿瘤 骨转移 放射性核素显像 SPECT CT 诊断 

分 类 号：TL99[核科学技术—核技术及应用]