常规SPECT/CT断层融合显像诊断高危前列腺癌患者骨转移  

Routine SPECT/CT fusion imaging in diagnosis of bone metastasis patients with high-risk prostate cancer

作　　者：张林启 覃艺芳 李伟[1] 张汝森[1] 伍秀青 袁道彰[2] 任志刚[1] 李雯[1] 李靖[2] 钟熹[3] ZHANG Linqi QIN YiJang LI Wei ZHANG Rusen WU Xiuqing YUAN Daozhang REN Zhigang LI Wen LI Jing ZHONG Xi(Department of Nuclear Medicine Department of Urology Department of Radiology, Cancer Center of Guangzhou Medical University, Guangzhou 510095, China)

机构地区：[1]广州医科大学附属肿瘤医院核医学科,广东广州510095 [2]广州医科大学附属肿瘤医院泌尿外科,广东广州510095 [3]广州医科大学附属肿瘤医院放射科,广东广州510095

出　　处：《中国医学影像技术》2017年第2期260-264,共5页Chinese Journal of Medical Imaging Technology

基　　金：广东省医学科学技术研究基金(A2016611)

摘　　要：目的探讨常规SPECT/CT断层融合显像诊断高危前列腺癌患者骨转移的价值。方法前瞻性连续的收集53例初诊为高危前列腺癌的患者进行常规全身骨显像(WBS)及SPECT/CT断层融合显像;对所有患者病灶的WBS、SPECT/CT图像进行定性分析,计算WBS、SPECT/CT显像诊断前列腺癌骨转移的准确率。结果符合纳入标准的患者46例,20例患者共85个病灶确诊为骨转移;以患者为单位,SPECT/CT的诊断准确率为89.13%(41/46),明显高于WBS(27/46,58.70%;χ~2=11.05,P=0.001),SPECT/CT诊断骨转移的灵敏度为90.00%(18/20),高于WBS[35.00%(7/20);χ~2=12.91,P<0.001];以病灶为单位SPECT/CT诊断的准确率为97.84%(136/139),高于WBS[70.50%(98/139);χ~2=38.99,P<0.001],SPECT/CT诊断骨转移的灵敏度为100%(85/85),高于WBS[89.41%(76/85);χ~2=9.50,P=0.002]。结论常规SPECT/CT断层融合显像能早期发现、准确诊断高危前列腺癌患者的骨转移。Objective To explore the value of routine 99 Tcm-MDP SPECT/CT image in diagnosis of bone metastasis for the patient with high-risk prostate cancer（PCa）.Methods Totally 53 consecutive patients with newly diagnosed high-risk PCa were enrolled.All patients underwent whole-body scintigraphy（WBS）,followed by whole-body SPECT/CT fusion imaging.Images of WBS and SPECT/CT were analyzed qualitativly.Sensitivity and accuracy of WBS,SPECT/CT in diagnosis of bone metastasis were calculated.Results Fourty-six patients were included in the study.Bone metastases were confirmed in 20 patients with 85 lesions.The diagnosis accuracy of SPECT/CT was 89.13%（41/46）on a per-patient basis,significantly higher than that of WBS（27/46,58.70%;χ~2=11.05,P=0.001）.Sensitivity of SPECT/CT in diagnosis of bone metastasis was 90.00%（18/20）on a per-patient basis,significantly higher than that of WBS（7/20,35.00%;χ~2=12.91,P〈0.001）.The diagnosis accuracy of SPECT/CT was 97.84%（136/139）on all per-lesion basis,significantly higher than that of WBS（98/139,70.50%;χ~2=38.99,P〈0.001）;Sensitivity of SPECT/CT in diagnosis of bone metastasis was 100%（85/85）on all per-lesion basis,significantly higher than that of WBS（76/85,89.41%;χ~2=9.50,P=0.002）.Conclusion SPECT/CT contributes to early detection and exact diagnosis of bone metastases.

关 键 词：前列腺肿瘤 骨 肿瘤转移 体层摄影术 发射型计算机 单光子 同位素标记 

分 类 号：R737.25[医药卫生—肿瘤] R814.42[医药卫生—临床医学]