^(99)Tc^m-MDP SPECT全身骨显像联合CT诊断脊柱结核的临床价值  

The clinical value of whole body bone imaging by ^(99)Tc^m-MDP SPECT combined CT in spinal tuberculosis

作　　者：杨兴[1] 刘启榆[1] 陈正国[1] 何瑜[1] 王东[1] 

机构地区：[1]绵阳市中心医院核医学科,四川绵阳621000

出　　处：《中国医学装备》2016年第5期72-76,共5页China Medical Equipment

摘　　要：目的:评价^(99)Tc^m-MDP SPECT全身骨显像联合CT诊断脊柱结核的临床价值。方法:回顾性分析68例临床筛选可疑脊柱结核患者,先行^(99)Tc^m-MDP SPECT全身骨显像,针对脊柱受累情况进行CT检查,对诊断结果与病理及随访结果进行评价。结果:病理诊断符合脊柱结核59例,转移性骨肿瘤3例,化脓性脊柱炎1例;随访结果符合脊柱结核4例;1例正常。全身骨显像联合CT诊断脊柱结核60例,其中误诊2例;2例诊断转移性骨肿瘤与病理诊断相符;1例未见异常;5例描述性诊断。联合诊断脊柱结核灵敏度为92.1%,特异度为60.0%,准确率为89.7%,假阳性率为40.0%,假阴性率为7.9%,阳性结果预测值为96.7%,阴性结果预测值为37.5%。结论:^(99)Tc^m-MDP SPECT全身骨显像联合CT诊断脊柱结核具有极高的临床价值,可指导CT扫描范围的选择,提高脊柱结核诊断的准确率。Objective：To evaluate the clinical value of the whole body bone imaging by99Tcm-MDP SPECT combined CT in diagnosing the spinal tuberculosis.Methods： 68 clinical screening cases were made the whole body bone scan by 99Tcm-MDP SPECT at first, performed with CT scan according to the radionuclide distribution of spine and finally compared the diagnosis with the pathological diagnosis or the follow-up results. Results： In the pathological diagnosis, 59 cases were spinal tuberculosis, 3 cases were metastatic bone tumors, and one case was pyogenic spondylitis. Then 4 cases were spinal tuberculosis and one case was normal in the follow-up results. There were 60 cases of spinal tuberculosis, including 2 cases of misdiagnosis in the diagnosis of the whole body bone imaging combined CT. 2 cases were diagnosed metastatic bone tumors which consistent with the pathological diagnosis. One case was nothing abnormal detected and 5 cases were descriptive diagnosis. The sensitivity of the diagnosis of spinal tuberculosis was 92.1%（58/63）, the specificity was 60.0%, the accurate rate was 89.7%（61/68）, the false positive rate was 40.0%, the false negative rate was 7.9%, the positive predictive value was 96.7%（58/60）, and the projections negative result was 37.5.%. Conclusion： There was good clinical value in diagnosing the spinal tuberculosis using the whole body bone imaging by 99Tcm-MDP SPECT combined CT which could control the range of CT scan and improve the accuracy of the spinal tuberculosis diagnosis.

关 键 词：单光子发射型电子计算机断层扫描仪 99Tcm-亚锡亚甲基二膦酸盐 全身骨显像 CT 脊柱结核 

分 类 号：R817.4[医药卫生—影像医学与核医学]