SPECT/CT及MRI定位骨质疏松性椎体压缩性骨折疼痛责任椎体的价值比较  

Comparison of the Value of SPECT/CT and MRI in Locating the Vertebrae Responsible for Pain in Osteoporotic Vertebral Compression Fractures

作　　者：刘红莲 尤徐阳[1] 龚亨 胡艳文 金振涛 LIU Honglian;YOU Xuyang;GONG Heng;HU Yanwen;JIN Zhentao(Department of Nuclear Medicine,Suzhou Ninth Hospital Affiliated to Soochow University,Suzhou,Jiangsu Province,215000 China;Department of Imaging,Suzhou Ninth Hospital Affiliated to Soochow University,Suzhou,Jiangsu Province,215000 China)

机构地区：[1]江苏省苏州市苏州大学附属苏州九院核医学科,江苏苏州215000 [2]江苏省苏州市苏州大学附属苏州九院影像科,江苏苏州215000

出　　处：《世界复合医学》2023年第12期55-58,共4页World Journal of Complex Medicine

摘　　要：目的评估单光子发射型计算机断层摄影术联合同机CT扫描图像融合技术(single-photon emission computed tomography-computed tomography,SPECT/CT)及磁共振成像(magnetic resonance imaging,MRI)在骨质疏松性椎体压缩性骨折(osteoporotic vertebral compression fracture,OVCF)中疼痛责任椎体的定位价值。方法方便收集2021年2月—2023年5月苏州大学附属苏州九院收治的32例接受SPECT/CT及MRI检查确认疼痛责任椎体后行手术治疗的OVCF患者的临床资料,并以手术结果(手术后疼痛缓解或消失而明确的疼痛责任椎体)为金标准,比较SPECT/CT与MRI检查在定位疼痛责任椎体中的价值。结果32例患者中,手术最终明确OVCFs的疼痛责任椎体43个,其中MRI检查出责任节段47个,SPECT/CT检查出责任节段51个。SPECT/CT骨显像检查灵敏度为90.70%,特异性为67.57%,阳性预测值76.47%,阴性预测值86.21%,准确率80.00%;MRI检查灵敏度为100.00%,特异性为89.19%,阳性预测值91.49%,阴性预测值100.00%,准确率95.00%。结论MRI对定位OVCF疼痛责任椎体的诊断价值较高,但对于无法行MRI检查的患者,可采用SPECT/CT替代诊疗。Objective To evaluate the value of single-photon emission computed tomography-computed tomography(SPECT/CT)and magnetic resonance imaging(MRI)in locating the vertebrae responsible in osteoporotic vertebral compression fracture(OVCF).Methods Clinical data of thirty-two OVCF patients admitted to Suzhou Ninth Hospital Affiliated to Soochow University from February 2021 to May 2023 who underwent surgical treatment after SPECT/CT and MRI examination to confirm the vertebral body responsible for pain were conveniently collected.The value of SPECT/CT versus MRI in locating vertebrae responsible was compared with surgical outcome(defined pain-responsible vertebrae with pain relief or disappearance after surgery)as the gold standard.Results Among the 32 patients,43 vertebrae responsible for pain in OVCFs were identified by surgery,of which 47 were identified by MRI and 51 were identified by SPECT/CT.SPECT/CT bone imaging had a sensitivity of 90.70%,specificity of 67.57%,positive predictive value of 76.47%,negative predictive value of 86.21%,and accuracy of 80.00%.The sensitivity of MRI was 100.00%,the specificity was 89.19%,the positive predictive value was 91.49%,the negative predictive value was 100.00%and the accuracy was 95.00%.Conclusion MRI is of high diagnostic value in locating the vertebrae responsible for OVCF pain,but SPECT/CT can be used as an alternative diagnosis and treatment for patients who cannot undergo MRI.

关 键 词：单光子发射型计算机断层摄影术联合同机CT扫描图像融合技术 磁共振成像 骨质疏松椎体压缩性骨折 

分 类 号：R687.3[医药卫生—骨科学]