^(18)F-FDG PET/CT显像 联合MRI对检测恶性肿 瘤骨转移的效能分析  

Efficac y Analysis of ^(18)F-FDG PET/CT Imaging Combined with MRI In Detecting Bone Metastasis of Malignant Tumors

作　　者：苏祁[1] 张堃[2] 郭忠聪[3] 陈小丽[1] 马桂杰 苏友贤 SU Qi;ZHANG Kun;GUO Zhong-cong;CHEN Xiao-li;MA Gui-jie;SU You-xian(PET-CT Center,the First Affiliated Hospital of Hunan University of Chinese Medicine,Changsha 410007,Hunan Province,China;Department of Radiological Imaging,the First Affiliated Hospital of Hunan University of Chinese Medicine,Changsha 410007,Hunan Province,China;Department of Oncology,the First Affiliated Hospital of Hunan University of Chinese Medicine,Changsha 410007,Hunan Province,China)

机构地区：[1]湖南中医药大学第一附属医院PET-CT中心,湖南长沙410007 [2]湖南中医药大学第一附属医院放射影像科,湖南长沙410007 [3]湖南中医药大学第一附属医院肿瘤科,湖南长沙410007

出　　处：《中国CT和MRI杂志》2025年第4期181-184,共4页Chinese Journal of CT and MRI

基　　金：湖南省卫生健康委科研计划项目(C202309048470)。

摘　　要：目的探究^(18)F-脱氧葡萄糖(^(18)F-FDG)正电子发射断层扫描/X线计算机扫描(PET/CT)显像联合核磁共振(MRI)诊断恶性肿瘤骨转移的效能。方法选取2023年1月至2024年3月在本院确诊的恶性肿瘤患者100例作为研究对象,在开展相关治疗前患者均接受^(18)F-FDG PET/CT、MRI检查。以病检作为金标准,分析2种检查方法单一及联合在恶性肿瘤骨转移中的诊断效能。结果100例恶性肿瘤患者中,经检查证实发生骨转移55例,临床随访追踪证实6例,共计61例患者发生骨转移,发生率为61.00%。^(18)F-FDG PET/CT检查显示骨转移57例,非骨转移43例;其诊断骨转移的灵敏度为88.52%(54/61),特异度为92.31%(36/39),准确率为90.00%(90/100),阳性预测值为94.74%(54/57),阴性预测值为83.72%(36/43),Kappa值为0.794。MRI检查显示骨转移55例,非骨转移45例;其诊断骨转移的灵敏度为83.61%(51/61),特异度为89.74%(35/39),准确率为86.00%(86/100),阳性预测值为92.73%(51/55),阴性预测值为77.78%(35/45)Kapp值为0.714。两种检查方法的灵敏度、特异度、准确率、阳性预测值、阴性预测值等比较无统计学差异(P>0.05)。骨转移组患者的骨转移病灶最大标准摄取值(SUV max)为(9.60±1.43),较非骨转移组的(2.22±0.21)更高(P<0.05)。^(18)F-FDG PET/CT、MRI诊断恶性肿瘤骨转移的曲线下面积(AUC)为0.932(95%CI为0.864-0.973),灵敏度与特异度分别为96.70%和89.70%。结论^(18)F-FDG PET/CT与MRI检查均在在恶性肿瘤骨转移中具有良好的诊断效能,二者联合诊断准确率更高。Objective To investigate the efficacy of ^(18)F-deoxyglucose(^(18)F-FDG)positron emission tomography/X-ray computer scan(PET/CT)imaging combined with nuclear magnetic resonance(MRI)in the diagnosis of bone metastases in malignant tumors.Methods 100 patients with malignant tumors diagnosed in our hospital from January 2023 to March 2024 were selected as research objects,and all patients received ^(18)F-FDG PET/CT and MRI examination before relevant treatment.To analyze the diagnostic efficacy of the two diagnostic methods in the diagnosis of bone metastasis of malignant tumors by single and combined examination.Results Among 100 patients with malignant tumors,55 cases were confirmed by examination and 6 cases were confirmed by clinical follow-up.A total of 61 patients had bone metastasis,with an incidence of 61.00%.^(18)F-FDG PET/CT showed 57 cases of bone metastasis and 43 cases of non-bone metastasis.The sensitivity,specificity and accuracy of bone metastasis were 88.52%(54/61),92.31%(36/39),90.00%(90/100),positive predictive value was 94.74%(54/57),negative predictive value was 83.72%(36/43)and Kapp value was 0.794.MRI showed bone metastasis in 55 cases and non-bone metastasis in 45 cases.The sensitivity,specificity and accuracy were 83.61%(51/61),89.74%(35/39),86.00%(86/100),positive predictive value was 92.73%(51/55),negative predictive value was 77.78%(35/45)and Kapp value was 0.714.There were no significant differences in sensitivity,specificity,accuracy,positive predictive value and negative predictive value between the two methods(P>0.05).The maximum focal value(SUV max)of bone metastasis group was(2.60±0.43),which was higher than that of non-bone metastasis group(2.22±0.21)(P<0.05).The AUC of ^(18)F-FDG PET/CT and MRI in the diagnosis of malignant bone metastases was 0.932(95%CI was 0.864-0.973),and the sensitivity and specificity were 96.70% and 89.70%.Conclusion Both ^(18)F-FDG PET/CT and MRI have good diagnostic efficacy in malignant bone metastasis,and their combined diagnostic accuracy is higher.

关 键 词：恶性肿瘤 骨转移 正电子发射断层显像 计算机体层成像 病理检查 

分 类 号：R445[医药卫生—影像医学与核医学]