SPECT-CT融合图像评价原发性肝癌骨转移的增益价值  

Incremental diagnostic value of SPECT-CT fusion imaging for bone metastases from primary liver cancer

作　　者：肇博[1] 左长京[1] 董爱生[1] 王小姣[1] 彭烨[1] 李晓红[1] 茅娟莉[1] 潘文舟[1] 徐登仁[1] 

机构地区：[1]第二军医大学附属长海医院核医学科,上海200433

出　　处：《中国医学前沿杂志（电子版）》2014年第10期151-153,共3页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

摘　　要：目的探讨SPECT-CT融合图像评价原发性肝癌骨转移的增益价值。方法回顾性分析临床诊断为原发性肝癌、排除其他恶性肿瘤病史且行全身骨显像及局部SPECT-CT融合图像检查的254例患者的临床资料,根据患者综合表现诊断为肿瘤骨转移和无肿瘤骨转移,以手术病理或随访结果为最终诊断标准。分别计算并比较全身骨显像、SPECT-CT融合图像诊断的灵敏度、特异度、阳性预测值、阴性预测值和正确诊断百分率。结果 254例患者中确诊肿瘤骨转移111例,无肿瘤骨转移143例。SPECT-CT融合图像诊断的灵敏度(93.6%)、特异度(93.7%)、阳性预测值(99%)、阴性预测值(100%)、正确诊断百分率(93.3%)均高于全身骨扫描(42.3%、74.8%、95.7%、92.5%、56.7%)。结论评价肝癌骨转移时,SPECT-CT融合图像较全身骨显像更具有增益价值。Objective To investigate the incremental diagnostic value of SPECT-CT fusion imaging for bone metastases from primary liver cancer. Method A total of 254 patients with primary liver cancer but without other malignancy, confirmed by clinical, underwent routine whole-body bone scintigraphy and local SPECTCT. Patients were divided into positive bone metastases group, negative bone metastases group and uncertain group according to the comprehensive manifestation. The final diagnosis was confirmed by clinical follow-up or surgical pathology. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of WBBS and SPECT-CT for cases were computed and compared. Result Within 254 patients, 111 were diagnosed as positive bone metastases and other 143 patients were diagnosed as negative bone metastasis. Sensitivity, specificity, positive predictive value, negative predictive value, diagnostic accuracy of SPECT-CT for cases were 93.6%, 93.7%, 99.0%, 100.0%, 93.3%, respectively, much higher than those of WBBS（42.3%, 74.8%, 95.7%, 92.5%, 56.7%）. Conclusion SPECT-CT fusion imaging provides incremental diagnostic value over routine whole-body bone scintigraphy for bone metastases from primary carcinoma of the liver.

关 键 词：原发性肝癌 肝癌骨转移 SPECT-CT融合图像 全身骨显像 

分 类 号：R735.7[医药卫生—肿瘤]