SPECT/CT联合MRI诊断鼻咽癌早期颅底骨侵犯的价值探析  

Analysis of Value of SPECT/CT Combined with MRI in the Diagnosis of Early Skull Base Invasion of Nasopharyngeal Carcinoma

作　　者：李立峰 薛艳丽 王乃武 LI Li-feng;XUE Yan-li;WANG Nai-wu(Department of Nuclear Medicine1,Jinan City People's Hospital,Jinan 271100,Shandong Province,China)

机构地区：[1]济南市人民医院核医学科,山东济南271100 [2]济南市人民医院影像科,山东济南271100

出　　处：《中国CT和MRI杂志》2020年第9期56-59,共4页Chinese Journal of CT and MRI

摘　　要：目的探讨单光子发射计算机体层成像CT(SPECT/CT)联合MRI诊断鼻咽癌早期颅底骨侵犯的价值。方法选取济南市人民医院2016年8月至2018年8月收治的83例具有MRI及SPECT-CT影像资料的鼻咽癌患者,以患者症状、影像及随访为定性结果,分析MRI、SPECT-CT及联合检查的诊断情况。结果 83例鼻咽癌患者中,52例(62.65%)存在颅底骨侵犯;MRI、SPECT-CT诊断结果不一致共28例,其中,MRI正确率46.43%(13/28),SPECT-CT正确率53.57%(15/28),差异无统计学意义(P>0.05);MRI+SPECT-CT敏感度较单独行MRI或单独行SPECT-CT显著升高(P<0.05),漏诊率显著降低(P<0.05);准确度、特异度三组比较差异无统计学意义(P>0.05);增加SPECT-CT影像报告后,有33例(39.76%)患者临床决策发生变化。结论 SPECT/CT联合MRI能提高鼻咽癌患者早期颅底骨侵犯敏感度,减少漏诊,影响患者临床决策。Objective To explore the value of single photon emission computed tomography CT (SPECT/CT) combined with MRI in the diagnosis of early skull base invasion of nasopharyngeal carcinoma.Methods 83 cases of patients with nasopharyngeal carcinoma who underwent MRI and SPECT-CT imaging from August 2016 to August 2018 were selected.The patients’ symptoms,imaging and follow-up were used as qualitative results to analyze the diagnosis conditions of MRI,SPECT-CT and combined diagnosis.Results Among 83 patients with nasopharyngeal carcinoma,52 cases (62.65%) were with skull base invasion.The diagnostic results of MRI and SPECT-CT were inconsistent in 28 cases.Among them,the correct rate of MRI was 46.43% (13/28),and the correct rate of SPECT-CT was 53.57% (15/28) (P>0.05).The sensitivity of MRI+SPECT-CT was significantly increased compared with that of MRI alone or SPECT-CT alone (P<0.05),and the rate of missed diagnosis was significantly decreased (P<0.05).There were no significant differences in the accuracy and specificity among the three groups (P>0.05).After addition of SPECT-CT image report,33 cases (39.76%) were with changes of clinical decision-making.Conclusion SPECT/CT combined with MRI can improve the sensitivity of early skull base invasion in patients with nasopharyngeal carcinoma,reduce missed diagnosis and affect clinical decision-making.

关 键 词：单光子发射计算机体层成像-CT 磁共振成像 鼻咽癌 早期颅底骨侵犯 

分 类 号：R739.62[医药卫生—肿瘤] R445.2[医药卫生—临床医学]