国际放射医学核医学杂志
國際放射醫學覈醫學雜誌
국제방사의학핵의학잡지
INTERNATIONAL JOURNAL OF RADIATION MEDICINE AND NUCLEAR MEDICINE
2011年
2期
89-92
,共4页
刘道佳%唐明灯%林端瑜%倪雷春%林小敏
劉道佳%唐明燈%林耑瑜%倪雷春%林小敏
류도가%당명등%림단유%예뢰춘%림소민
脊柱%肿瘤转移%体层摄影术,发射型计算机%单光子%体层摄影术,X线计算机%氟脱氧葡萄糖F18%99m锝美罗酸盐
脊柱%腫瘤轉移%體層攝影術,髮射型計算機%單光子%體層攝影術,X線計算機%氟脫氧葡萄糖F18%99m锝美囉痠鹽
척주%종류전이%체층섭영술,발사형계산궤%단광자%체층섭영술,X선계산궤%불탈양포도당F18%99m득미라산염
Spine%Neoplasm metastasis%Tomography,emission-computed,single-photon%Tomography,X-ray computed%Fluorodeoxyglucose F18%Technetium Tc 99m medronate
目的 比较99Tcm-亚甲基二膦酸盐(99Tcm-MDP)全身骨显像、99Fcm-MDPSPECT-CT与18F-FDG SPECT-CT诊断脊柱转移瘤的临床价值.方法 对行常规99Tcm-MDP全身骨显像的88例肿瘤患者同时行99Tcm-MDP SPECT-CT,同期(2周内)行18F-FDG SPECT-CT.回顾性分析患者临床资料,以病理结果或两种以上影像技术(MRI、CT等)结果或随访2年以上结果为最终结果,比较99Tcm-MDP全身骨显像、99Tcm-MDP SPECT-CT与18F-FDG SPECT-CT的诊断结果.结果 经临床随访或病理证实,88例肿瘤患者诊断脊柱转移瘤48例、良性病变19例、未转移2l例.99Tcm-MDP全身骨显像诊断脊柱转移瘤的灵敏度、特异度、阳性预测值、阴性预测值及准确率分别为89.6%(43/48)、62.5%(25/40)、74.1%(43/58)、83.3%(25/30)及63.4%(68/88),99Tcm-MDP SPECT-CT分别为93.8%(45/48)、92.5%(35/40)、90.0%(45/50)、92.1%(35/38)及81.6%(80/88);18F-FDG SPECT-CT分别为97.9%(47/48)、97.5%(39/40)、97.9%(48/49)、97.5%(39/40)及87.8%(86/88).SPECT-CT解决了99Tcm-MDP全身骨显像对阳性病灶精确解剖定位难的问题,明显提高了对骨良性病灶的诊断能力,降低了诊断脊柱转移瘤的假阳性率.18F-FDG SPECT-CT较99Tcm-MDP全身骨显像更具肿瘤特异性,对骨骼良恶性病灶的鉴别具有更强的能力,提高了脊柱转移瘤诊断的特异度(X2=15.313,P＜0.001)和准确率(X2=16.831,P＜0.001).结论 99Tcm-MDP SPECT-CT和18F-FDG SPECT-CT对脊柱转移瘤的诊断效能高于99Tcm-MDP全身骨显像,具有较高的临床价值.
目的 比較99Tcm-亞甲基二膦痠鹽(99Tcm-MDP)全身骨顯像、99Fcm-MDPSPECT-CT與18F-FDG SPECT-CT診斷脊柱轉移瘤的臨床價值.方法 對行常規99Tcm-MDP全身骨顯像的88例腫瘤患者同時行99Tcm-MDP SPECT-CT,同期(2週內)行18F-FDG SPECT-CT.迴顧性分析患者臨床資料,以病理結果或兩種以上影像技術(MRI、CT等)結果或隨訪2年以上結果為最終結果,比較99Tcm-MDP全身骨顯像、99Tcm-MDP SPECT-CT與18F-FDG SPECT-CT的診斷結果.結果 經臨床隨訪或病理證實,88例腫瘤患者診斷脊柱轉移瘤48例、良性病變19例、未轉移2l例.99Tcm-MDP全身骨顯像診斷脊柱轉移瘤的靈敏度、特異度、暘性預測值、陰性預測值及準確率分彆為89.6%(43/48)、62.5%(25/40)、74.1%(43/58)、83.3%(25/30)及63.4%(68/88),99Tcm-MDP SPECT-CT分彆為93.8%(45/48)、92.5%(35/40)、90.0%(45/50)、92.1%(35/38)及81.6%(80/88);18F-FDG SPECT-CT分彆為97.9%(47/48)、97.5%(39/40)、97.9%(48/49)、97.5%(39/40)及87.8%(86/88).SPECT-CT解決瞭99Tcm-MDP全身骨顯像對暘性病竈精確解剖定位難的問題,明顯提高瞭對骨良性病竈的診斷能力,降低瞭診斷脊柱轉移瘤的假暘性率.18F-FDG SPECT-CT較99Tcm-MDP全身骨顯像更具腫瘤特異性,對骨骼良噁性病竈的鑒彆具有更彊的能力,提高瞭脊柱轉移瘤診斷的特異度(X2=15.313,P＜0.001)和準確率(X2=16.831,P＜0.001).結論 99Tcm-MDP SPECT-CT和18F-FDG SPECT-CT對脊柱轉移瘤的診斷效能高于99Tcm-MDP全身骨顯像,具有較高的臨床價值.
목적 비교99Tcm-아갑기이련산염(99Tcm-MDP)전신골현상、99Fcm-MDPSPECT-CT여18F-FDG SPECT-CT진단척주전이류적림상개치.방법 대행상규99Tcm-MDP전신골현상적88례종류환자동시행99Tcm-MDP SPECT-CT,동기(2주내)행18F-FDG SPECT-CT.회고성분석환자림상자료,이병리결과혹량충이상영상기술(MRI、CT등)결과혹수방2년이상결과위최종결과,비교99Tcm-MDP전신골현상、99Tcm-MDP SPECT-CT여18F-FDG SPECT-CT적진단결과.결과 경림상수방혹병리증실,88례종류환자진단척주전이류48례、량성병변19례、미전이2l례.99Tcm-MDP전신골현상진단척주전이류적령민도、특이도、양성예측치、음성예측치급준학솔분별위89.6%(43/48)、62.5%(25/40)、74.1%(43/58)、83.3%(25/30)급63.4%(68/88),99Tcm-MDP SPECT-CT분별위93.8%(45/48)、92.5%(35/40)、90.0%(45/50)、92.1%(35/38)급81.6%(80/88);18F-FDG SPECT-CT분별위97.9%(47/48)、97.5%(39/40)、97.9%(48/49)、97.5%(39/40)급87.8%(86/88).SPECT-CT해결료99Tcm-MDP전신골현상대양성병조정학해부정위난적문제,명현제고료대골량성병조적진단능력,강저료진단척주전이류적가양성솔.18F-FDG SPECT-CT교99Tcm-MDP전신골현상경구종류특이성,대골격량악성병조적감별구유경강적능력,제고료척주전이류진단적특이도(X2=15.313,P＜0.001)화준학솔(X2=16.831,P＜0.001).결론 99Tcm-MDP SPECT-CT화18F-FDG SPECT-CT대척주전이류적진단효능고우99Tcm-MDP전신골현상,구유교고적림상개치.
Objective To co mpare the value of 99Tcm-methylene diphosphonate (99Tcm-MDP)bone scintigraphy, 99Tcm-MDP SPECT-CT and 18F-FDG in detecting bone metastases of spine. Methods Retro-spective analysis of 88 tumor patients who underwent 99Tcm-MDP planar bone scintigraphy, then performed 99Tcm-MDP SPECT-CT immediately, and then underwent 18F-FDG SPECT-CT within 2 weeks apart. The diagnostic results were confirmed by biopsy, MRI/CT and clinical follow-up. Results Fouty-eight of 88 patients were comfirmed to be spine bone metastases, 19 to be spine benigns, 21 to be non-metastases. The sensitivity, specificity, positivity predicitive value, negative predictive value, and accuracy of 99Tcm-MDP bone scintigraphy were 89.6%(43/48), 62.5%(25/40), 74.1% (43/58), 83.3% (25/30)and 63.4%(68/88). Those of 9Tcm-MDP SPECTCT were 93.8% (45/48), 92.5%(35/40), 90.0% (45/50), 92.1% (35/38)and 81.6%(80/88). Those of 18F-FDG SPECT-CT were 97.9% (47/48), 97.5% (39/40), 97.9% (48/49), 97.5% (39/40)and 87.8% (86/88). SPECT-CT is resolving the problem in conventional bone scintigraphy on anatomical localization of the positive lesions on bone, and reducing the false positive rate. 18F-FDG SPECT-CT is more specific than 99Tcm-MDP bone scintigraphy to the bone metastases of spine, and increasing the ability to identify bone lesion malignant or benign, and increasing the specificity(X2=15.313, P＜0.001 ) and accuracy(X2=16.831, P＜0.001 ). Conclusion The diagnostic accuracy of 99Tcm-MDP SPECT-CTand 18F-FDG SPECT-CTin detecting bone metastases of spine are both better than 99Tcm-MDP BS.They are valuable for detecting bone metastases of spine.
