(99m)Tc-MDP SPECT/CT断层融合显像鉴别脊柱良恶性病变的价值分析  

(99m)Tc-MDP SPECT/CT Tomographic Fusion Imaging to Differentiate the Value of Benign and Malignant Spinal Lesions

作　　者：靳永辉 张晓霞 张丽莉 JIN Yong-hui;ZHANG Xiao-xia;ZHANG Li-li(Department of Nuclear Medicine,Hebi People's Hospital,Hebi 458000 China)

机构地区：[1]鹤壁市人民医院核医学科,河南鹤壁458000

出　　处：《内蒙古医学杂志》2021年第12期1453-1455,F0002,共4页Inner Mongolia Medical Journal

基　　金：河南省自然科学基金项目(编号:LHGJ20190292)。

摘　　要：目的探讨(99m)锝亚甲基二磷酸盐(Tc-MDP)单光子发射计算机断层扫描/X线计算机断层扫描(SPECT/CT)断层融合显像鉴别脊柱良恶性病变的价值分析。方法选取2018年8月至2020年8月在本院确诊的脊柱病变患者120例(120个病灶),所有患者均进行(99m)Tc-MDPSPECT全身平面骨显像和局部SPECT/CT断层融合显像检查,所有病灶均以病理检查或随访6个月以上的结果无明显恶化作为最终诊断结果。根据病理结果分为良性病变组90例和恶性病变组30例,比较两种方法的灵敏度、特异度、准确度、阳性检测率和阴性检出率等以及诊断结果。结果SPECT检测出良性病变组的阳性率为88.89%,显著低于SPECT/CT检测出阳性率的91.11%(P<0.05);SPECT检测出恶性病变组的阳性率为26.67%,显著低于SPECT/CT检测出阳性率的33.33%(P<0.05);SPECT全身平面骨显像鉴别的特异度、灵敏度、准确度、阳性预测值、阴性预测值、kappa值分别为73.33%、88.89%、85.00%、88.89%、73.33%、0.608;显著低于SPECT/CT断层融合显像的76.67%、91.11%、87.50%、91.11%、76.67%、0.670(P<0.05)。结论SPECT/CT断层融合显像对脊柱良恶性病变鉴别价值较高。Objective To explore the value analysis of(99m)technetium methylene diphosphate(Tc-MDP)single photon emission computed tomography/X-ray computed tomography(SPECT/CT)tomographic fusion imaging in distinguishing benign and malignant spinal lesions.Methods A total of 120 patients(120 lesions)with spinal lesions diagnosed in our hospital from August 2018 to August 2020 were selected.All patients underwent(99m)Tc-MDPSPECT whole body planar bone imaging and local SPECT/CT tomographic fusion.Like the examination,all lesions were diagnosed as the final diagnosis result by pathological examination or the result of follow-up for more than 6 months without significant deterioration.According to the pathological results,they were divided into benign lesion group(90 cases)and malignant lesion group(30 cases).The sensitivity,specificity,accuracy,positive detection rate and negative detection rate of the two methods were compared,and the diagnosis results were compared.Results The positive rate of benign lesions detected by SPECT was 88.89%,which was significantly lower than 91.11%of the positive rate detected by SPECT/CT(P<0.05);the positive rate of malignant lesions detected by SPECT was 26.67%,which was significantly lower than that of SPECT.The positive rate of/CT detection was 33.33%(P<0.05);the specificity,sensitivity,accuracy,positive predictive value,negative predictive value,and kappa value of SPECT whole body planar bone imaging were 73.33%,88.89%,and 85.00,respectively%,88.89%,73.33%,0.608;significantly lower than 76.67%,91.11%,87.50%,91.11%,76.67%,0.670 of SPECT/CT tomographic fusion imaging(P<0.05).Conclusion SPECT/CT tomographic fusion imaging is of high value in distinguishing benign and malignant spinal lesions.

关 键 词：(99m)锝亚甲基二磷酸盐 单光子发射计算机断层扫描/X线计算机断层扫描 脊柱 

分 类 号：R681.5[医药卫生—骨科学]