SPECT/CT骨显像在肿瘤骨转移患者中的应用观察  

Application of bone imaging with SPECT/CT in patients with bone metastases

作　　者：汤辉[1] 苏新辉[1] 张红[1] 陈盛优 傅雪妹[1] 

机构地区：[1]厦门大学附属中山医院核医学科,361004

出　　处：《临床医学》2017年第5期26-28,共3页Clinical Medicine

摘　　要：目的研究SPECT/CT骨显像在肿瘤骨转移患者中的应用。方法 560例恶性肿瘤患者行全身骨显像,根据全身骨显像发现有核素浓聚灶的局部进行SPECT断层显像、CT扫描,后进行图像融合。虽然全身骨显像无核素浓聚灶,但因为局部疼痛,仍针对局部进行SPECT断层显像、CT扫描,同样进行图像融合。随后由两名以上具有主治医师以上职称的核医学医生联合对全身骨显像和融合图像先后做出诊断。以病理、MRI检查及6个月后随访作为确诊标准。对SPECT全身骨显像与SPECT/CT骨显像所诊断结果及其灵敏度、特异度、阳性预测值、阴性预测值及诊断符合度进行分析。结果 SPECT全身骨显像与SPECT/CT骨显像在肿瘤骨转移的灵敏度分别为94.5%、96.1%(P>0.05),特异度分别为78.7%、97.7%(P<0.05),阳性预测值分别为56.8%、92.5%(P<0.05),阴性预测值为98.0%、98.8%(P>0.05),诊断符合度为82.3%、97.3%(P<0.05)。结论 SPECT全身骨显像诊断肿瘤骨转移的灵敏度较高,SPECT/CT骨显像较SPECT全身骨显像明显提高肿瘤骨转移的特异度、阴性预测值和诊断符合率。Objective To study the application of bone imaging with SPECT/CT in patients with bone metastases.Methods Five hundred and sixty malignant tumor patients underwent whole body bone imaging. According to the whole body bone imaging,it was found that there were a local SPECT tomography,CT scan,and the image fusion in the concentration range of the nuclear. Although the whole body bone imaging did not have the nuclear concentration,but because of local pain,still for the local SPECT tomography,CT scan,the same image fusion. Then by more than two doctors with the above title of the nuclear medicine doctor in combination with the whole body bone imaging and fusion image had made diagnosis. With pathology,MRI examination and follow-up after six months as the standard of diagnosis.The sensitivity,specificity,positive predictive value,negative predictive value and diagnostic accuracy of SPECT total body bone scan and bone scan with SPECT/CT were analyzed. Results The sensitivity of SPECT whole body bone imaging and bone imaging using SPECT/CT in bone metastases were 94. 5%,96. 1%,respectively（ P〈0. 05）; the specificity were78. 7%,97. 7% respectively（ P〈0. 05）; the positive predictive value were 56. 8%,92. 5% respectively（ P〈0. 05）;the negative predictive value were 98. 0%,98. 8% respectively（ P〈0. 05）; the diagnostic accuracy were 82. 3%,97. 3%respectively（ P〈0. 05）. Conclusion The sensitivity of SPECT bone imaging in the diagnosis of bone metastases is very high. Bone imaging using SPECT/CT compared with SPECT whole body bone imaging significantly increased the specificity,negative predictive value and diagnostic accuracy of tumor bone metastasis.

关 键 词：单光子发射型计算机断层扫描仪/计算机断层扫描 骨显像 骨转移 

分 类 号：R730.44[医药卫生—肿瘤]