中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2014年
21期
19-22
,共4页
肺肿瘤%肋骨%体层摄影术%发射型计算机%单光子
肺腫瘤%肋骨%體層攝影術%髮射型計算機%單光子
폐종류%륵골%체층섭영술%발사형계산궤%단광자
Pulmonary neoplasm%Ribs%Tomography%Emission-computed%Single-photon
目的 分析肺癌患者SPECT/CT同机融合显像肋骨单发病灶的特征和临床诊断之间的相互关系,并评价定位CT在诊断中的作用.方法 在SPECT全身骨显像中发现肋骨单发病灶68例肺癌患者加行SPECT/CT同机融合显像,所有病变按位置分为前肋、侧肋、后肋、肋骨与肋软骨交界处四个部位,按病灶形状分为点状和条形两种,并进行分类分析,同时分析SPECT全身骨显像和SPECT/CT同机融合显像方法的诊断效能.结果 SPECT全身骨显像肋骨骨折所致单发浓聚灶占52.94％(36/68);条形病灶中肋骨转移占91.30％(21/23);肋骨与肋软骨交界处病灶都呈点状,全部为良性病变;后肋病灶中肋骨转移占81.82％(18/22).SPECT全身骨显像和SPECT/CT同机融合显像诊断单发浓聚灶骨转移敏感度分别为69.23％(18/26),92.31％(24/26),特异度59.52％(25/42),85.71％ (36/42),准确度63.24％ (43/68),88.24％ (60/68),阳性预测值51.43％(18/35),80.00％(24/30),阴性预测值75.76％(25/33),94.74％(36/38).二者敏感度比较差异有统计学意义(P＜0.05),特异度和准确度比较差异有统计学意义(P＜0.01).结论 肋骨单发病灶良恶性病变具有一定的图像特点,对于鉴别诊断具有十分重要的临床意义,SPECT/CT同机融合显像提高了诊断的准确性.
目的 分析肺癌患者SPECT/CT同機融閤顯像肋骨單髮病竈的特徵和臨床診斷之間的相互關繫,併評價定位CT在診斷中的作用.方法 在SPECT全身骨顯像中髮現肋骨單髮病竈68例肺癌患者加行SPECT/CT同機融閤顯像,所有病變按位置分為前肋、側肋、後肋、肋骨與肋軟骨交界處四箇部位,按病竈形狀分為點狀和條形兩種,併進行分類分析,同時分析SPECT全身骨顯像和SPECT/CT同機融閤顯像方法的診斷效能.結果 SPECT全身骨顯像肋骨骨摺所緻單髮濃聚竈佔52.94％(36/68);條形病竈中肋骨轉移佔91.30％(21/23);肋骨與肋軟骨交界處病竈都呈點狀,全部為良性病變;後肋病竈中肋骨轉移佔81.82％(18/22).SPECT全身骨顯像和SPECT/CT同機融閤顯像診斷單髮濃聚竈骨轉移敏感度分彆為69.23％(18/26),92.31％(24/26),特異度59.52％(25/42),85.71％ (36/42),準確度63.24％ (43/68),88.24％ (60/68),暘性預測值51.43％(18/35),80.00％(24/30),陰性預測值75.76％(25/33),94.74％(36/38).二者敏感度比較差異有統計學意義(P＜0.05),特異度和準確度比較差異有統計學意義(P＜0.01).結論 肋骨單髮病竈良噁性病變具有一定的圖像特點,對于鑒彆診斷具有十分重要的臨床意義,SPECT/CT同機融閤顯像提高瞭診斷的準確性.
목적 분석폐암환자SPECT/CT동궤융합현상륵골단발병조적특정화림상진단지간적상호관계,병평개정위CT재진단중적작용.방법 재SPECT전신골현상중발현륵골단발병조68례폐암환자가행SPECT/CT동궤융합현상,소유병변안위치분위전륵、측륵、후륵、륵골여륵연골교계처사개부위,안병조형상분위점상화조형량충,병진행분류분석,동시분석SPECT전신골현상화SPECT/CT동궤융합현상방법적진단효능.결과 SPECT전신골현상륵골골절소치단발농취조점52.94％(36/68);조형병조중륵골전이점91.30％(21/23);륵골여륵연골교계처병조도정점상,전부위량성병변;후륵병조중륵골전이점81.82％(18/22).SPECT전신골현상화SPECT/CT동궤융합현상진단단발농취조골전이민감도분별위69.23％(18/26),92.31％(24/26),특이도59.52％(25/42),85.71％ (36/42),준학도63.24％ (43/68),88.24％ (60/68),양성예측치51.43％(18/35),80.00％(24/30),음성예측치75.76％(25/33),94.74％(36/38).이자민감도비교차이유통계학의의(P＜0.05),특이도화준학도비교차이유통계학의의(P＜0.01).결론 륵골단발병조량악성병변구유일정적도상특점,대우감별진단구유십분중요적림상의의,SPECT/CT동궤융합현상제고료진단적준학성.
Objective To analyze the imaging features and clinical significance of solitary costal hot spots in patient with lung cancer on SPECT/CT fusion imaging and the value of low-dose CT for diagnosis.Methods SPECT/CT scan was performed on 68 patients with lung cancer and costal single hot spots using whole body bone imaging.The sites of lesions were classified into four types:junction between costal cartilage and rib,frontal rib,lateral rib,posterior rib.The shapes of lesions were classified into two forms:punctiform and strip shapes,and were analyzed and classified.The differences of the diagnosis of whole body bone imaging and SPECT/CT scan were analyzed.Results Punctiform spots were mainly due to costal fractures(36/68,52.94％).The majority of spots in strip shape were costal metastases (21/23,91.30％).The lesions of junction between costal cartilage and rib were punctiform shape and benign.Hot spots in posterior ribs were mainly costal metastases (18/22,81.82％).Sensitivity of diagnosis of the metastatic bone tumor with whole body bone imaging and SPECT/CT in single hot spot of spine and rib was 69.23％ (18/26) and 92.31％(24/26),specificity 59.52％(25/42) and 85.71％(36/42),accuracy 63.24％(43/68) and 88.24％ (60/68),positive predictive value 51.43％ (18/35) and 80.00％ (24/30),negative predictive value 75.76％ (25/33) and 94.74％ (36/38).SPECT/CT scan had differences with whole body bone imaging in sensitivity (P ＜ 0.05),SPECT/CT scan had significant differences with whole body bone imaging in coincidence and specificity (P ＜ 0.01).Conclusions Useful imaging features can be obtained from SPECT/CT fusion imaging with single costal hot spots,being helpful to differential diagnosis of benign and malignant lesions.SPECT/CT fusion imaging may improve the accuracy to diagnose the rib disease.
