CAJ | 학술논문

目的探讨三相骨显像联合SPECT/CT对骨骼良恶性病变鉴别诊断较单纯三相骨显像的增益价值.方法回顾分析2008年7月至2011年9月间临床怀疑骨肿瘤、并行三相骨显像联合SPECT/CT显像的45例患者,其中男28例,女17例,年龄11～82(44.1±21.2)岁.病灶均经外科手术治疗或穿刺活组织检查获得病理诊断.2位核医学科医师先分析三相骨显像图,判断病变良恶性；在其基础上,结合SPECT/CT融合图像分析,再次判断病变良恶性.与病理诊断结果比较,分别对单纯三相骨显像和SPECT/CT联合三相骨显像对患者病灶良恶性诊断效能进行分析.采用SPSS 16.0软件,以x2检验比较2种方法诊断的准确性.结果病理诊断恶性病变29例,良性病变16例.三相骨显像和SPECT/CT联合三相骨显像对骨骼良恶性病变的诊断灵敏度分别为96.6％(28/29)和100％(29/29),特异性分别为37.5％(6/16)和81.2％(13/16),阳性预测值分别为73.7％(28/38)和90.6％(29/32),阴性预测值分别为6/7和100％(13/13).三相骨显像诊断准确性为75.6％(34/45),SPECT/CT联合三相骨显像诊断准确性提高至93.3％(42/45),两者差异有统计学意义(x2=4.145,P＜0.05).结论 SPECT/CT联合三相骨显像对骨骼病灶良恶性病变判断的准确性较三相骨显像明显提高,具有增益价值.
목적 탐토삼상골현상연합SPECT/CT대골격량악성병변감별진단교단순삼상골현상적증익개치.방법 회고분석2008년7월지2011년9월간림상부의골종류、병행삼상골현상연합SPECT/CT현상적45례환자,기중남28례,녀17례,년령11～82(44.1±21.2)세.병조균경외과수술치료혹천자활조직검사획득병리진단.2위핵의학과의사선분석삼상골현상도,판단병변량악성；재기기출상,결합SPECT/CT융합도상분석,재차판단병변량악성.여병리진단결과비교,분별대단순삼상골현상화SPECT/CT연합삼상골현상대환자병조량악성진단효능진행분석.채용SPSS 16.0연건,이x2검험비교2충방법진단적준학성.결과 병리진단악성병변29례,량성병변16례.삼상골현상화SPECT/CT연합삼상골현상대골격량악성병변적진단령민도분별위96.6％(28/29)화100％(29/29),특이성분별위37.5％(6/16)화81.2％(13/16),양성예측치분별위73.7％(28/38)화90.6％(29/32),음성예측치분별위6/7화100％(13/13).삼상골현상진단준학성위75.6％(34/45),SPECT/CT연합삼상골현상진단준학성제고지93.3％(42/45),량자차이유통계학의의(x2=4.145,P＜0.05).결론 SPECT/CT연합삼상골현상대골격병조량악성병변판단적준학성교삼상골현상명현제고,구유증익개치.
Objective To investigate the added value of SPECT/CT combined with three-phase bone scintigraphy for differential diagnosis in patients with suspected bone tumor compared with 99Tcm-MDP three-phase bone scintigraphy.Methods Forty-five patients with mean age (44.1 ±21.2) years who were suspected to have bone tumors,underwent 99Tcm-MDP three-phase bone scintigraphy and SPECT/CT between July 2008 and September 2011.They were retrospectively reviewed.All patients had pathological diagnosis based on surgical resection or lesion biopsy.The three-phase bone scintigraphy images were analyzed,and combined SPECT/CT images were then analyzed by two experienced nuclear medicine physicians.The third nuclear medicine physician would be consulted if there was disagreement between these two investigators.Each lesion was diagnosed as either malignant or benign.Compared with the pathology diagnosis,the diagnostic ability of three-phase bone scintigraphy images and SPECT/CT combined with threephase bone scintigraphy were evaluated.The diagnostic accuracy of three-phase bone scintigraphy images and SPECT/CT combined with three-phase bone scintigraphy were calculated,and x2 test was used to compare the difference between them.Results Among these 45 lesions,29 were malignant and 16 benign.Using three-phase bone scintigraphy and SPECT/CT combined with three-phase bone scintigraphy for the differential diagnosis of bone lesions,the sensitivity,specificity,positive predictive value and negative predictive value were 96.6％ (28/29) vs 100％ (29/29),37.5％ (6/16) vs 81.2％ (13/16),73.7％ (28/38) vs 90.6％ (29/32),and 6/7 vs 100％ (13/13),respectively.The diagnostic accuracy of the three-phase bone scintigraphy was 75.6％ (34/45),and up to 93.3％ (42/45) for the combined examination (x2 =4.145,P ＜0.05).Conclusions Compared with three-phase bone scintigraphy alone,the diagnostic accuracy of SPECT/CT combined with three-phase bone scintigraphy is significantly improved.The combination might provide added value over three-phase bone scintigraphy for differential diagnosis in patients with suspected bone tumor.