SPECT／CT显像对脊柱良恶性病变诊断的增益价值  

The added value of SPECT/CT imaging for diagnosing benign and malignant lesions of spine

作　　者：张雪辉[1] 孔飚[1] 肖国有[2] 许梅本 姚少红[1] 高永旺[1] 陈方旎[2] 杨贵生[2] 

机构地区：[1]北海市人民医院、广西医科大学第九附属医院核医学科,536000 [2]广西医科大学附属肿瘤医院核医学科,南宁530021

出　　处：《中华核医学与分子影像杂志》2016年第2期156-160,共5页Chinese Journal of Nuclear Medicine and Molecular Imaging

基　　金：广西壮族自治区卫生厅课题，Guangxi Zhuang Autonomous Region Project of Department of Public Health

摘　　要：目的 评价^99Tcm－MDP SPECT/CT显像在骨显像脊柱阳性病灶良恶性诊断方面的增益价值。方法 回顾性对比分析2012年1月至2013年12月间103例（男49例，女54例，平均年龄62.1岁）注射^99Tcm－MDP后180 min全身骨显像有脊柱阳性病灶患者的SPECT、CT及两者同机融合图像资料。以病理结果、影像学检查或随访结果（≥6个月）为诊断依据，分析SPECT/CT显像及平面骨显像对脊柱阳性病灶的诊断能力。结果 103例患者共149处病灶，平面骨显像确诊（良性病变和恶性病变）病灶37处，占24.8%（37/149）；SPECT/CT显像确诊病灶132处，占88.6%（132/149）。与平面骨显像对比，SPECT/CT显像对诊断有帮助者136处，占91.3%（136/149）；不确定11处和无帮助2处，共13处，占8.7%（13/149）。全身平面骨显像和SPECT/CT显像对脊柱良恶性病变确诊率差异有统计学意义（χ^2＝23.77，P〈0.05）。结论 SPECT/CT显像对脊柱阳性病灶的良恶性鉴别诊断较平面骨显像能够提供更多的诊断信息，具有较高的增益价值。Objective To evaluate the added value of SPECT/CT imaging in identifying the spinal hot spots of ^99Tcm-MDP imaging.Methods From January 2012 to December 2013 a total of 103 patients （49 males, 54 females; average age： 62.1 years） with spinal hot spot by whole-body bone imaging were retrospectively analyzed. Patients underwent SPECT/CT imaging 180 min after ^99Tcm-MDP injection. Images of whole body bone imaging and SPECT/CT imaging were analyzed. Final diagnosis was determined by pathological examination, trans-spinal biopsy or follow-up （≥6 months）.Results There were 149 spinal lesions in 103 patients. The planar bone imaging detected 37 benign and malignant lesions （24.8%, 37/149）, and SPECT/CT imaging detected 132 benign and malignant lesions（88.6%, 132/149）. Moreover, SPECT/CT images provided additional confidence for image interpretation （helpful 91.3%（136/149）, unsure and not helpful 8.7%（13/149））.Conclusion SPECT/CT imaging provides more information than planar whole body bone imaging in differential diagnosis of spinal lesions.

关 键 词：脊柱疾病 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：R738[医药卫生—肿瘤] R730.44[医药卫生—临床医学]