CAJ | 학술논문

目的探讨SPECT/CT骨显像在肺癌骨转移诊断中的增益价值.方法 146例病理证实为肺癌的患者,静脉注射99Tcm-MDP1110 MBq,3～6 h后按常规方法行全身骨显像.由1位资深核医学科医师分析全身骨显像图像后,决定是否行SPECT/CT显像以及显像视野范围,然后采集SPECT和CT图像.由2位核医学科医师先对全身骨显像的平面图像进行分析,然后分析SPECT/CT融合图像并诊断,诊断分为肿瘤骨转移、无肿瘤骨转移和不能确定.根据术后病理或随访获得正确诊断,分别计算全身骨显像、SPECT/CT融合图像对患者能正确(肿瘤骨转移和无肿瘤骨转移)诊断和不能正确诊断(不能确定和诊断错误)的百分率及其95%可信区间,并分别计算其诊断与最终诊断的符合率及其95%可信区间.全身骨显像和SPECT/CT能否正确诊断的百分率比较采用x2检验.结果全身骨显像正确诊断者65例,占44.5%(65/146);不能正确诊断者81例,占55.5%(81/146),其95%可信区间为47.4%～63.5%;骨转移诊断的符合率为64.4%(29/45).SPECT/CT融合图像能正确诊断者131例,占89.7%(131/146);不能正确诊断者15例,占10.3%(15/146),其95%可信区间为5.3%～15.2%;骨转移诊断的符合率为93.3%(42/45).SPECT/CT融合图像的明确诊断率高于全身骨显像(x2=69.598,P＜0.05).结论 SPECT/CT骨显像在肺癌骨转移诊断中较全身骨显像有增益价值,可以提供更多的诊断信息.
목적 탐토SPECT/CT골현상재폐암골전이진단중적증익개치.방법 146례병리증실위폐암적환자,정맥주사99Tcm-MDP1110 MBq,3～6 h후안상규방법행전신골현상.유1위자심핵의학과의사분석전신골현상도상후,결정시부행SPECT/CT현상이급현상시야범위,연후채집SPECT화CT도상.유2위핵의학과의사선대전신골현상적평면도상진행분석,연후분석SPECT/CT융합도상병진단,진단분위종류골전이、무종류골전이화불능학정.근거술후병리혹수방획득정학진단,분별계산전신골현상、SPECT/CT융합도상대환자능정학(종류골전이화무종류골전이)진단화불능정학진단(불능학정화진단착오)적백분솔급기95%가신구간,병분별계산기진단여최종진단적부합솔급기95%가신구간.전신골현상화SPECT/CT능부정학진단적백분솔비교채용x2검험.결과 전신골현상정학진단자65례,점44.5%(65/146);불능정학진단자81례,점55.5%(81/146),기95%가신구간위47.4%～63.5%;골전이진단적부합솔위64.4%(29/45).SPECT/CT융합도상능정학진단자131례,점89.7%(131/146);불능정학진단자15례,점10.3%(15/146),기95%가신구간위5.3%～15.2%;골전이진단적부합솔위93.3%(42/45).SPECT/CT융합도상적명학진단솔고우전신골현상(x2=69.598,P＜0.05).결론 SPECT/CT골현상재폐암골전이진단중교전신골현상유증익개치,가이제공경다적진단신식.
Objective To investigate the added diagnostic value of SPECT/CT imaging over routine planar whole-body bone scintigraphy (WBBS) for bone metastases from lung cancer. Methods One hundred and forty-six patients with lung cancer, confirmed by pathological examination, underwent routine 99Tcm-MDP (1110 MBq) WBBS, followed by SPECT/CT over the regions with indeterminate findings on WBBS. Both WBBS and bone SPECT/CT images were interpreted by two experienced nuclear medicine physicians in consensus as the positive, negative or uncertain bone metastases. The final diagnosis was comfirmed by pathology or clinical follow-up. x2 test was used to compare the differences between the two imaging methods. Results Finally, 45 patients were diagnosed as positive bone metastases and the other 101 as negative. The diagnostic sensitivity of bone SPECT/CT for bone metastases from lung cancer was 93.3%(42/45), singnificantly higher than that of WBBS (64.4%, 29/45) (x2 = 19.944, P＜0.05). The diagnostic accuracy of bone SPECT/CT was 89.7% ( 131/146), much higher than that of WBBS (44.5%,65/146) ( x2 = 69. 598,P ＜ 0.05). The uncertain and incorrect diagnostic rates of bone SPECT/CT and WBBS were 10.3% ( 15/146, raging from 5.3% to 15.2% with 95% confidence interval (CI) ) and 55.5% (81/146, raging from 47. 4% to 63.5% with95% CI), respectively. Conclusion BoneSPECT/CT provides incremental diagnostic value over routine WBBS for bone metastases from lung cancer.