论著-头颈部
SPECT/CT融合图像与全身骨显像对骨转移瘤诊断的价值分析
作者:王 东1 孟宪平1 陈则君1 靳激扬2
所属单位:1.东南大学医学院附属江阴医院影像科 (江苏 江阴 214400) 2.东南大学医学院附属中大医院影像科 (江苏 南京 210000)
PDF摘要
目的探讨SPECT/CT融合图 像与全身骨显像 ( w h o l e - b o d y b o n e scintigraphy,WBBS)对骨转移瘤的价值 比较。方法 回顾性分析我院 80例可疑肿 瘤骨转移性病变患者行WBBS及SPECT/CT断 层图像融合,所有结果都通过病理或进一 步随访等方式确诊。分别计算并比较两种 结果对病例及病灶诊断的灵敏度、特异 度、阳性预测值、阴性预测值、正确诊 断百分率。结果 80例患者骨转移61例, 19例为良性病例,258处病灶中,骨转移 202处,良性病灶为56处。WBBS对病例及 病灶诊断的灵敏度分别为82%和89.1%,特 异度分别为42.1%和31.7%,阳性预测值 分别为82%和84.7%,阴性预测值分别为 42.1%和40.6%,准确率72.5%和78.1%。 SPECT/CT对病例及病灶诊断的灵敏度分 别为98.4%和98%,特异度分别为52.6%和 76.8%,阳性预测值分别为87%和93.8%, 阴性预测值分别为90.9%和91.5%,准确 率为87.5%和83.4%。两组数据均经过χ2 检验,P<0.05。结论 在骨转移瘤的诊断 中,SPECT/CT融合图像较WBBS明显更具有 诊断价值。
Objective To investigate the comparison of SPECT/CT fusion image and whole body bone imaging(whole-body ipads scintigraphy, WBBS) in bone metastasis value. Methods retrospective analysis of 80 cases of suspected tumor bone metastatic disease underwent whole-body bone imaging and SPECT/CT fault image fusion in our hospital, all the results are confirmed by pathology and further follow-up and otherwise. Calculate and compare the two results of cases and lesions diagnosed degree of sensitivity, specific percentage, positive predictive value, negative predictive value, the correct diagnosis. Results 80 patients, 61 cases of bone metastases, 19 cases were benign, 258 lesions, the bone metastases, 202 benign lesions is 56. The sensitivity of WBBS for diagnosis of patients and lesions were 82% and 89.1%, the specificity was 42.1% and 31.7% respectively, the positive predictive value were 82% and 84.7%, and negative predictive values were 42.1% and 40.6%, the percentage of correct diagnosis was 72.5% and 78.1%. The sensitivity of SPECT/CT for diagnosis of patients and lesions were 98.4% and 98%, the specificity was 52.6% and 76.8% respectively, the positive predictive value were 87% and 93.8%, and negative predictive values were 90.9% and 91.5%, the percentage of correct diagnosis was 87.5% and 83.4%.Both sets of data after the χ2 test, P<0.05. Conclusion In the diagnosis of bone metastasis, SPECT/CT fusion image is more obvious than WBBS has diagnostic value.
【关键词】骨转移瘤;全身骨显像; SPECT/CT融合图像
【中图分类号】R738.1;R445.6
【文献标识码】A
【DOI】 10.3969/j.issn.1672- 5131.2016.04.038
前言
骨转移瘤为骨骼中最常见的恶性肿瘤,其是否出现将直接影响 肿瘤的分期以及对患者综合治疗的判断。放射性核素骨显像简便快 捷,一次成像即可显示全身骨骼的情况,是目前公认的诊断肿瘤骨 转移最有效的方法之一[1],其特点为灵敏度高,但特异度相对较差, 所以一般需结合其他检查方能做出准确判断。SPECT/CT融合显像对全 身骨显像中不确定病灶及无明显放射性浓聚的病灶具有重要的鉴别诊 断价值,因其可以提供更准确的解剖信息来增加对骨转移瘤的诊断可 信度。SPECT/CT可通过1次检查同时获得病灶部位的SPECT和CT诊断信 息,从而有效提高骨骼病变诊断的准确性[2,3]。本研究拟对比WBBS与 SPECT/CT在诊断骨转移瘤的诊断效能及临床应用价值。
中国CT和MRI杂志
第14卷, 第 4 期
2016年04月
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