中华核医学杂志
中華覈醫學雜誌
중화핵의학잡지
CHINESE JOURNAL OF NUCLEAR MEDICINE
2011年
6期
386-389
,共4页
董薇%李眉%戴皓洁%陈慧东
董薇%李眉%戴皓潔%陳慧東
동미%리미%대호길%진혜동
神经母细胞瘤%肿瘤转移%骨骼%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
神經母細胞瘤%腫瘤轉移%骨骼%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
신경모세포류%종류전이%골격%체층섭영술,발사형계산궤,단광자%체층섭영술,X선계산궤%MDP
Neuroblastoma%Neoplasm metastasis%Skeleton%Tomography,emission-computed,single-photon%Tomography,X-ray computed%MDP
目的 探讨SPECT和CT融合骨显像在探测小儿神经母细胞瘤(NB)转移性骨肿瘤中的临床价值.方法 回顾性分析24例NB患儿,均行全身平面骨显像及局部SPECT和CT融合骨显像.将骨病灶显示的清晰度分为5级(不可见、模糊、可见、清晰、非常清晰),良恶性诊断的确定性分为3级(不确定、可以确定、十分确定),诊断效能指标包括灵敏度、特异性及准确性.对显像图像在骨病灶的清晰度显示、良恶性确定性诊断及探测恶性骨病灶的诊断效能方面进行分析,采用秩和检验及x2检验进行比较.结果 24例NB患儿,全身平面骨显像发现骨病灶72个,有5个骨病灶未能显示,SPECT和CT融合显像和单独SPECT显像均分别发现骨病灶77个.对骨病灶的清晰度显示SPECT和CT融合显像,单独SPECT显像均优于平面显像(H值均为69.000,P均＜0.05).平面显像和SPECT显像诊断恶性骨病灶的准确性分别为45.45％(35/77)和62.34％(48/77;x2 =4.416,P＜0.05),SPECT和CT融合诊断恶性骨病灶的灵敏度、特异性和准确性均较平面显像有提高,分别为82.35％ (42/51)和53.19％ (25/47)、88.46％ (23/26)和40.00％( 10/25)、84.42％ (65/77)和45.45％(35/77),x2=12.571,14.016和25.667,P均＜0.01.与SPECT显像的特异性(14/26,53.85％)和准确性(48/77,62.34％)相比,SPECT和CT融合诊断恶性骨病灶的特异性和准确性提高(x2 =7.589,9.606,P均＜0.01),两者间灵敏度差异无统计学意义(x2=2.942,P＞0.05).SPECT和CT融合显像骨病灶良恶性的确定性诊断优于SPECT(H=28.000,P＜0.05)和平面显像(H=21.000,P＜0.05).结论 SPECT和CT融合骨显像能探测到NB患儿更多的骨病灶,是一种较好的探测NB患儿转移性骨肿瘤的显像方法.
目的 探討SPECT和CT融閤骨顯像在探測小兒神經母細胞瘤(NB)轉移性骨腫瘤中的臨床價值.方法 迴顧性分析24例NB患兒,均行全身平麵骨顯像及跼部SPECT和CT融閤骨顯像.將骨病竈顯示的清晰度分為5級(不可見、模糊、可見、清晰、非常清晰),良噁性診斷的確定性分為3級(不確定、可以確定、十分確定),診斷效能指標包括靈敏度、特異性及準確性.對顯像圖像在骨病竈的清晰度顯示、良噁性確定性診斷及探測噁性骨病竈的診斷效能方麵進行分析,採用秩和檢驗及x2檢驗進行比較.結果 24例NB患兒,全身平麵骨顯像髮現骨病竈72箇,有5箇骨病竈未能顯示,SPECT和CT融閤顯像和單獨SPECT顯像均分彆髮現骨病竈77箇.對骨病竈的清晰度顯示SPECT和CT融閤顯像,單獨SPECT顯像均優于平麵顯像(H值均為69.000,P均＜0.05).平麵顯像和SPECT顯像診斷噁性骨病竈的準確性分彆為45.45％(35/77)和62.34％(48/77;x2 =4.416,P＜0.05),SPECT和CT融閤診斷噁性骨病竈的靈敏度、特異性和準確性均較平麵顯像有提高,分彆為82.35％ (42/51)和53.19％ (25/47)、88.46％ (23/26)和40.00％( 10/25)、84.42％ (65/77)和45.45％(35/77),x2=12.571,14.016和25.667,P均＜0.01.與SPECT顯像的特異性(14/26,53.85％)和準確性(48/77,62.34％)相比,SPECT和CT融閤診斷噁性骨病竈的特異性和準確性提高(x2 =7.589,9.606,P均＜0.01),兩者間靈敏度差異無統計學意義(x2=2.942,P＞0.05).SPECT和CT融閤顯像骨病竈良噁性的確定性診斷優于SPECT(H=28.000,P＜0.05)和平麵顯像(H=21.000,P＜0.05).結論 SPECT和CT融閤骨顯像能探測到NB患兒更多的骨病竈,是一種較好的探測NB患兒轉移性骨腫瘤的顯像方法.
목적 탐토SPECT화CT융합골현상재탐측소인신경모세포류(NB)전이성골종류중적림상개치.방법 회고성분석24례NB환인,균행전신평면골현상급국부SPECT화CT융합골현상.장골병조현시적청석도분위5급(불가견、모호、가견、청석、비상청석),량악성진단적학정성분위3급(불학정、가이학정、십분학정),진단효능지표포괄령민도、특이성급준학성.대현상도상재골병조적청석도현시、량악성학정성진단급탐측악성골병조적진단효능방면진행분석,채용질화검험급x2검험진행비교.결과 24례NB환인,전신평면골현상발현골병조72개,유5개골병조미능현시,SPECT화CT융합현상화단독SPECT현상균분별발현골병조77개.대골병조적청석도현시SPECT화CT융합현상,단독SPECT현상균우우평면현상(H치균위69.000,P균＜0.05).평면현상화SPECT현상진단악성골병조적준학성분별위45.45％(35/77)화62.34％(48/77;x2 =4.416,P＜0.05),SPECT화CT융합진단악성골병조적령민도、특이성화준학성균교평면현상유제고,분별위82.35％ (42/51)화53.19％ (25/47)、88.46％ (23/26)화40.00％( 10/25)、84.42％ (65/77)화45.45％(35/77),x2=12.571,14.016화25.667,P균＜0.01.여SPECT현상적특이성(14/26,53.85％)화준학성(48/77,62.34％)상비,SPECT화CT융합진단악성골병조적특이성화준학성제고(x2 =7.589,9.606,P균＜0.01),량자간령민도차이무통계학의의(x2=2.942,P＞0.05).SPECT화CT융합현상골병조량악성적학정성진단우우SPECT(H=28.000,P＜0.05)화평면현상(H=21.000,P＜0.05).결론 SPECT화CT융합골현상능탐측도NB환인경다적골병조,시일충교호적탐측NB환인전이성골종류적현상방법.
Objective To evaluate the diagnostic performance of bone SPECT and CT fusion imaging in bone metastases from pediatric neuroblastoma.Methods Twenty-four pediatric patients with neuroblastoma were included in this retrospective study.All patients underwent planar imaging and SPECT integrated with CT.Lesion visibility,diagnostic certainty and diagnostic performance were evaluated with KolmogorovSmirnov test andx2 test.Results Lesion visibility of SPECT alone,SPECT integrated with CT were significantly better than that of planar imaging ( both H =69.000,P ＜ 0.05 ).SPECT and CT fusion imaging,SPECT alone both detected five more bone lesions than planar bone imaging (77 vs 72).The diagnostic accuracy of SPECT imaging (62.34％,48/77 ) was significantly higher than that of planar imaging (45.45％,35/77; x2 =4.416,P ＜ 0.05 ).The sensitivity,specificity and accuracy of SPECT and CT fusion imaging for diagnosing malignant bone lesions were significantly higher than those of planar imaging:82.35％ (42/51) vs 53.19％ ( 25/47),88.46％ ( 23/26 ) vs 40.00％ ( 10/25 ),84.42％ ( 65/77 ) vs 45.45％ (35/77 ; x2 =12.571,14.016,25.667,all P ＜ 0.01 ).The diagnostic specificity and accuracy of SPECT and CT fusion imaging were significantly higher than those of SPECT alone ( 53.85％,14/26 ;62.34％,48/77) (x2 =7.589,9.606,both P ＜0.01 ).However,there was no significant difference of sensitivity between the two methods (x2 =2.942,P ＞ 0.05 ).Diagnostic certainty by SPECT and CT fusion imaging was significantly higher than that by SPECT alone ( H =28.000,P ＜ 0.05 ) and by planar imaging (H =21.000,P ＜ 0.05).Conclusion SPECT and CT fusion imaging can detect more bone lesions in patients with pediatric neuroblastoma.It is helpful for diagnosing bone metastases from pediatric neuroblastoma.
