SPECT/CT对骨显像疑难病灶的诊断增益分析  

Added value of SPECT/CT in assessment of suspected lesions on bone scanning

作　　者：林琳[1] 郑容[1,2] 刘琳[1] 贾莹莹[1] 耿建华[1] 

机构地区：[1]北京协和医学院中国医学科学院肿瘤医院核医学科,北京100021 [2]北京协和医学院中国医学科学院肿瘤医院PET/CT中心,北京100021

出　　处：《中国医学影像技术》2014年第4期560-563,共4页Chinese Journal of Medical Imaging Technology

基　　金：北京希望马拉松专项基金(LC2011B34)

摘　　要：目的探讨SPECT/CT对平面骨显像疑难病灶的诊断增益及其相关影响因素。方法回顾72例全身骨显像诊断疑难病灶的SPECT/CT检查结果,分析SPECT/CT诊断增益与病灶部位、摄取程度、CT特征及原发肿瘤病理类型的关系。结果 72例中,骨显像共发现140处诊断不确定病灶,65.00%(91/140)病灶经SPECT/CT显像后可以明确诊断。SPECT/CT对不同部位病灶的诊断增益率的差异有统计学意义(χ2=13.59,P=0.035)。经SPECT/CT融合显像后,脊柱病灶获得诊断增益率明显高于骨盆病灶(χ2=8.81,P=0.003)。SPECT/CT对不同摄取程度病灶的诊断增益率差异无统计学意义(χ2=2.76,P=0.43)。CT呈溶骨为主及具有良性特征的病灶经SPECT/CT显像获得的诊断增益高于成骨为主及混合性病灶。结论 SPECT/CT对诊断全身骨显像疑难病灶具有明确增益作用,病灶部位及CT特征是判断能否通过SPECT/CT融合显像获得明确诊断的重要因素。Objective To explore the added value of SPECT/CT in assessment of suspected lesions on bone scanning and relative factors. Methods Totally 72 patients with suspected lesions on bone scanning underwent SPECT/CT, and the re- sults were retrospectively analyzed. The relationship of added value of SPECT/CT and the position, uptake, CT character- istic of the lesions, the pathology of primary tumors were analyzed. Results In 72 patients, a total of 140 suspected lesions were found on bone scanning, and 65.00% （91/140） were confirmed by SPECT/CT. The added value of SPECT/CT to le- sions in different positions were significantly different （χ^2= 13. 59, P = 0. 035）, while of vertebral column lesions was higher than that of pelvis lesions （χ^2=8.81, P=0. 003）. The added value of SPECT/CT of different uptake level lesions were not significantly different （χ^2=2.76, P=0.43）. The added value of SPECT/CT for osteolytic lesions and lesions with benign characteristics on CT were higher than for osteoplastic or mixed lesions. Conclusion SPECT/CT has definitely added value for assessment of suspected lesions on bone scanning. The position and CT characteristics of lesions are main factors for whether the diagnosis could be confirmed with SPECT/CT.

关 键 词：骨和骨组织 肿瘤 体层摄影术 发射型计算机 单光子 

分 类 号：R817.4[医药卫生—影像医学与核医学] R681[医药卫生—放射医学]