99 Tcm －MDP SPECT／CT显像对乳腺癌脊椎病变的诊断价值研究  

Application of 99 Tcm -MDP SPECT/CT imaging for the diagnosis of spinal metastases in patients with breast cancer

作　　者：王宇峰[1] 何苗[1] 刘海娜[1] 张居洋[1] 张敬[1] 惠华[1] 

机构地区：[1]徐州市肿瘤医院核医学科,江苏徐州221003

出　　处：《徐州医学院学报》2015年第2期122-125,共4页Acta Academiae Medicinae Xuzhou

基　　金：徐州市科技计划项目（XM13B097）

摘　　要：目的：评价99Tcm－MDP（锝标记的亚锡亚甲基二磷酸盐）SPECT／CT显像对99Tcm －MDP全身骨显像难以确诊乳腺癌脊椎病灶的鉴别诊断价值。方法对99 Tcm －MDP全身骨显像难以确诊的97例乳腺癌患者的184个脊椎病灶行局部SPECT／CT显像。所有患者转移灶确诊以临床病理、MRI、CT、骨扫描检查为依据。结果①99 Tcm －MDP SPECT／CT显像对99Tcm －MDP全身骨显像难以确诊的184个脊椎病灶的诊断符合率为90．8％（167／184），对乳腺癌脊椎骨转移的诊断灵敏度为88．9％，特异度为92．2％，阳性预测值为90．0％，阴性预测值91．3％。②99 Tcm －MDP SPECT／CT显像对不同年龄组的脊柱病变诊断符合率不一致，青年组最高，其诊断符合率为96．4％（54／56），其次为中年组93．3％（56／60），最低为老年组83．8％（57／68），其差异有统计学意义（P＝0．01）。结论99 Tcm －MDP SPECT／CT显像能够对90．8％的99 Tcm －MDP全身骨显像难以确诊的脊椎病灶进行准确诊断，明显地提高了诊断准确性。99 Tcm －MDP SPECT／CT显像在青年及中年组的乳腺癌脊椎病灶中的诊断符合率最高，老年组较低。Objective To evaluate the application of 99 Tcm -MDP SPECT/CT imaging for the diagnosis of spinal metastases of patients with breast cancer who were difficult to be diagnosed using 99 Tcm -MDP bone scanning alone . Methods Clinical data from 97 patients with breast cancer patients （ totaling 184 spinal lesions ） were analyzed , in which the patients underwent local SPECT /CT fusion imaging due to their spinal metastases difficult to be determined by 99Tcm -MDP bone scanning.All patients were diagnosed based on their pathological , MRI, CT, bone scan or PET/CT results.Results When used in determining the spinal lesions in those difficult to be diagnosed by 99 Tcm -MDP bone scan, 99 Tcm -MDP SPECT/CT imaging resulted in 90.8%（167/184） correct rate.This imaging produced 88.9%sen-sitivity and 92 .2%specificity when determining the spinal metastases of breast cancer , where the positive and negative predictive percentages were 90.0%and 91.3%, respectively.When applied to determining the spinal lesions in patients within different age groups , 99 Tcm -MDP SPECT/CT imaging yielded various correct rates , detailing 96.4%（54/56） in the youth group, followed by 93.3%（56/60） in the middle-aged group and 83.8%（57/68） in the elder group （P=0.01）.Conclusion 99Tcm -MDP SPECT/CT imaging can remarkably improve the determination of spinal metastases in patients with breast cancer who are difficult to be diagnosed by 99 Tcm -MDP bone scanning alone , yielding a correct rate of 90.8%.This imaging can result in higher correct rates in the youth and middle -aged groups than that in the elder group .

关 键 词：单光子发射计算机断层成像术 乳腺癌 脊椎转移 

分 类 号：R445.67[医药卫生—影像医学与核医学]