中华核医学杂志
中華覈醫學雜誌
중화핵의학잡지
CHINESE JOURNAL OF NUCLEAR MEDICINE
2011年
3期
164-168
,共5页
张一洪%石洪成%顾宇参%修雁%李蓓蕾%朱玮珉%陈曙光%余浩军
張一洪%石洪成%顧宇參%脩雁%李蓓蕾%硃瑋珉%陳曙光%餘浩軍
장일홍%석홍성%고우삼%수안%리배뢰%주위민%진서광%여호군
脊柱疾病%诊断,鉴别%体层摄影术,发射型计算机,单光子%体层摄影术,X线计算机%MDP
脊柱疾病%診斷,鑒彆%體層攝影術,髮射型計算機,單光子%體層攝影術,X線計算機%MDP
척주질병%진단,감별%체층섭영술,발사형계산궤,단광자%체층섭영술,X선계산궤%MDP
Spinal diseases%Diagnosis,differential%Tomography,emission-computed,single-photon%Tomography,X-ray computed%MDP
目的 探讨99Tcm-MDP SPECT/CT骨显像对脊柱良、恶性病变的鉴别诊断价值.方法 回顾性分析52例全身骨显像示脊柱局灶性放射性异常浓聚者的SPECT/CT影像资料,并与病理结果对照.由2位核医学科医师用盲法阅片方法分别对SPECT图像和SPECT/CT融合图像进行病变良性、可能良性、可能恶性和恶性的判断.分别计算SPECT和SPECT/CT诊断结果中可能良性和可能恶性的百分比,并对2位阅片者的分析结果进行一致性分析,计算Kappa值和95%的可信区间.分析SPECT和SPECT/CT诊断结果与病理结果的一致率及95%可信区间.结果 2位阅片者分析SPECT图像,诊断为不确定(可能恶性和可能良性)的比例分别为73.1%(38/52)和67.3%(35/52),一致率为63.5%,Kappa值为0.62,95%可信区间为0.49～0.76;2位阅片者分析SPECT/CT图像,诊断为不确定的比例分别为25.0%(13/52)和13.5%(7/52),一致率为78.9%,Kappa值为0.81,95%可信区间为0.72～0.91.SPECT诊断与病理结果的一致率为76.9%,95%可信区间为63.8%～86.2%;SPECT/CT诊断与病理结果的一致率为94.2%,95%可信区间为84.3%～97.9%.结论 在全身骨平面显像基础上,对脊柱病变再行SPECT/CT显像,可以获得更多诊断信息.不同阅片者对SPECT/CT融合图像分析结果的一致性、SPECT/CT诊断病变良恶性与病理结果的一致性均较SPECT好.
目的 探討99Tcm-MDP SPECT/CT骨顯像對脊柱良、噁性病變的鑒彆診斷價值.方法 迴顧性分析52例全身骨顯像示脊柱跼竈性放射性異常濃聚者的SPECT/CT影像資料,併與病理結果對照.由2位覈醫學科醫師用盲法閱片方法分彆對SPECT圖像和SPECT/CT融閤圖像進行病變良性、可能良性、可能噁性和噁性的判斷.分彆計算SPECT和SPECT/CT診斷結果中可能良性和可能噁性的百分比,併對2位閱片者的分析結果進行一緻性分析,計算Kappa值和95%的可信區間.分析SPECT和SPECT/CT診斷結果與病理結果的一緻率及95%可信區間.結果 2位閱片者分析SPECT圖像,診斷為不確定(可能噁性和可能良性)的比例分彆為73.1%(38/52)和67.3%(35/52),一緻率為63.5%,Kappa值為0.62,95%可信區間為0.49～0.76;2位閱片者分析SPECT/CT圖像,診斷為不確定的比例分彆為25.0%(13/52)和13.5%(7/52),一緻率為78.9%,Kappa值為0.81,95%可信區間為0.72～0.91.SPECT診斷與病理結果的一緻率為76.9%,95%可信區間為63.8%～86.2%;SPECT/CT診斷與病理結果的一緻率為94.2%,95%可信區間為84.3%～97.9%.結論 在全身骨平麵顯像基礎上,對脊柱病變再行SPECT/CT顯像,可以穫得更多診斷信息.不同閱片者對SPECT/CT融閤圖像分析結果的一緻性、SPECT/CT診斷病變良噁性與病理結果的一緻性均較SPECT好.
목적 탐토99Tcm-MDP SPECT/CT골현상대척주량、악성병변적감별진단개치.방법 회고성분석52례전신골현상시척주국조성방사성이상농취자적SPECT/CT영상자료,병여병리결과대조.유2위핵의학과의사용맹법열편방법분별대SPECT도상화SPECT/CT융합도상진행병변량성、가능량성、가능악성화악성적판단.분별계산SPECT화SPECT/CT진단결과중가능량성화가능악성적백분비,병대2위열편자적분석결과진행일치성분석,계산Kappa치화95%적가신구간.분석SPECT화SPECT/CT진단결과여병리결과적일치솔급95%가신구간.결과 2위열편자분석SPECT도상,진단위불학정(가능악성화가능량성)적비례분별위73.1%(38/52)화67.3%(35/52),일치솔위63.5%,Kappa치위0.62,95%가신구간위0.49～0.76;2위열편자분석SPECT/CT도상,진단위불학정적비례분별위25.0%(13/52)화13.5%(7/52),일치솔위78.9%,Kappa치위0.81,95%가신구간위0.72～0.91.SPECT진단여병리결과적일치솔위76.9%,95%가신구간위63.8%～86.2%;SPECT/CT진단여병리결과적일치솔위94.2%,95%가신구간위84.3%～97.9%.결론 재전신골평면현상기출상,대척주병변재행SPECT/CT현상,가이획득경다진단신식.불동열편자대SPECT/CT융합도상분석결과적일치성、SPECT/CT진단병변량악성여병리결과적일치성균교SPECT호.
Objective To investigate the additional diagnostic value of 99Tcm-MDP SPECT/CT over conventional SPECT scan in patients with spinal bone malignancy. Methods Fifty-two patients (mean age (56±14) years) with suspicious spinal bone diseases underwent both bone SPECT and SPECT/CT imaging right after 99Tcm-MDP whole-body planar bone scintigraphy. All patients were pathologically diagnosed by either spine operation or trans-spinal biopsy. The images were evaluated by two independent reviewers; inter-reviewer agreement was evaluated using a weighted Kappa score. Each focus of abnormality was recorded using a 4-point diagnostic confidence scale: benign (B), possibly benign (PB), possibly malignant (PM) or malignant (M). Results Accord to the pathological results, 36 patients had bone malignancy (19 with metastatic tumors and 17 with non-metastatic tumors) and 16 had benign lesions. Over SPECT images, two reviewers rated 73.1% (38/52) and 67.3% (35/52) the lesions as the equivocal (PB or PM) respectively. Over SPECT/CT images, they rated only 25.0% (13/52) and 13.5% (7/52) lesions as the equivocal. Inter-reviewer agreement was 63.5% (weighted Kappa score=0.62) for SPECT and 78.9% (weighted Kappa score=0.81) for SPECT/CT. Conclusions Compared with99Tcm-MDP SPECT, 99Tcm-MDP SPECT/CT results in a significant reduction of equivocal diagnoses for the spinal bone malignancy.
