放射性核素骨显像联合磁共振全身弥散加权成像在乳腺癌骨转移鉴别诊断中的应用价值分析  

Application value of radionuclide bone imaging combined with whole body diffusion weighted imaging in differential diagnosis of bone metastasis of breast cancer

作　　者：唐森林 李倩 饶洪英 刘琪 陈晓良 Tang Senlin;Li Qian;Rao Hongying;Liu Qi;Chen Xiaoliang(Department of Nuclear Medicine,Chongqing University Cancer Hospital&Chongqing Cancer Institute&Chongqing Cancer Hospital,Chongqing 400030,China)

机构地区：[1]重庆大学附属肿瘤医院/重庆市肿瘤研究所/重庆市肿瘤医院核医学科,重庆400030

出　　处：《中国医学前沿杂志（电子版）》2021年第1期65-68,共4页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

基　　金：重庆市自然科学基金(cstc2018jcyjAX0819)。

摘　　要：目的探讨放射性核素骨显像联合磁共振全身弥散加权成像(whole body diffusion weighted imaging,WB-DWI)在乳腺癌骨转移鉴别诊断中的应用价值。方法纳入2017年1月至2019年6月重庆大学附属肿瘤医院收治的乳腺癌疑似骨转移患者90例为研究对象。比较胸/锁骨、肋骨、脊椎、骨盆处转移病灶与正常骨组织的表观弥散系数(apparent diffusion coeffecient,ADC)以及放射性核素骨显像、WB-DWI单独诊断与二者联合诊断乳腺癌骨转移的灵敏度、特异度、准确度。结果不同部位转移瘤的ADC均显著小于正常骨组织(均P<0.05);放射性核素骨显像诊断乳腺癌骨转移的灵敏度为79.31%,特异度为93.75%,准确度为84.44%;WB-DWI诊断的灵敏度为93.18%,特异度为84.78%,准确度为88.89%;两种方法联合诊断的灵敏度为97.92%,特异度为85.71%,准确度为92.22%。联合诊断的灵敏度、准确度均显著高于单独诊断。结论放射性核素骨显像联合WB-DWI可以提高乳腺癌骨转移诊断的灵敏度和准确度,可为制订临床决策提供重要参考。Objective To investigate the application value of radionuclide bone imaging combined with whole body diffusion weighted imaging(WB-DWI)in differential diagnosis of bone metastasis of breast cancer.Method A total of 90 patients with suspected bone metastasis of breast cancer treated in Chongqing University Cancer Hospital from January 2017 to June 2019 were included in the study.The apparent diffusion coeffecient(ADC)of metastatic lesions in chest/clavicle,rib,spine and pelvis and normal bone tissue,and the sensitivity,specificity and accuracy of radionuclide bone imaging,WB-DWI alone and combined diagnosis of bone metastasis of breast cancer.Result The sensitivity,specificity and accuracy of radionuclide bone imaging in the diagnosis of bone metastasis of breast cancer were 79.31%,93.75%and 84.44%,respectively.The sensitivity,specificity and accuracy of WB-DWI were 93.18%,84.78%and 88.89%,respectively.The sensitivity,specificity and accuracy of the combined diagnosis of the two methods were 97.92%,85.71%and 92.22%,respectively.The sensitivity and accuracy of combined diagnosis were significantly higher than those of single diagnosis.Conclusion Radionuclide bone imaging combined with WB-DWI can improve the sensitivity and accuracy of diagnosis of bone metastasis of breast cancer and provide an important reference for clinical decision-making.

关 键 词：放射性核素骨显像 磁共振全身弥散加权成像 乳腺癌 骨转移 鉴别诊断 

分 类 号：R737.9[医药卫生—肿瘤]