CAJ | 학술논문

目的探讨SPECT/CT融合显像在单个股骨头颈部或转子区病变诊断中的应用价值.方法在2007年1月至2008年6月进行99Tcm-亚甲基二膦酸盐(MDP)全身骨显像的患者中,94例股骨头颈或转子区异常放射性分布不能明确诊断,遂行SPECT/CT显像,并通过随访得到患者的病理诊断或综合影像诊断.对病变的SPECT图像、CT图像及SPECT/CT融合图像的诊断符合率进行对比,并分析转移性肿瘤及良性病变的影像特征.采用SPSS 13.0软件行McNemar检验.结果排除失访及最后未明确诊断者,最终入选患者78例.根据随访结果,确定良性病灶59例,转移性肿瘤19例.SPECT、CT及融合图像对78例病灶的诊断符合率分别为59.0%(46/78),87.2%(68/78),96.2%(75/78),SPECT、CT图像分别与融合图像比较,差异均有统计学意义(X2=16.48和48.18,P均＜0.05).结论在对肿瘤患者进行骨显像中发现的股骨头颈或转子区病变以良性病变居多,SPECT/CT融合显像可提高其诊断准确性.
목적 탐토SPECT/CT융합현상재단개고골두경부혹전자구병변진단중적응용개치.방법 재2007년1월지2008년6월진행99Tcm-아갑기이련산염(MDP)전신골현상적환자중,94례고골두경혹전자구이상방사성분포불능명학진단,수행SPECT/CT현상,병통과수방득도환자적병리진단혹종합영상진단.대병변적SPECT도상、CT도상급SPECT/CT융합도상적진단부합솔진행대비,병분석전이성종류급량성병변적영상특정.채용SPSS 13.0연건행McNemar검험.결과 배제실방급최후미명학진단자,최종입선환자78례.근거수방결과,학정량성병조59례,전이성종류19례.SPECT、CT급융합도상대78례병조적진단부합솔분별위59.0%(46/78),87.2%(68/78),96.2%(75/78),SPECT、CT도상분별여융합도상비교,차이균유통계학의의(X2=16.48화48.18,P균＜0.05).결론 재대종류환자진행골현상중발현적고골두경혹전자구병변이량성병변거다,SPECT/CT융합현상가제고기진단준학성.
Objective The study was aimed to evaluate the value of SPECT/CT in assessment of femoral foci of abnormal bone metabolism classified as indeterminate on bone scanning using 99Tcm-methylene diphosphonate(MDP).Methods There were 94 patients with solitary femoral abnormal uptake in bone scanning included.SPECT was accompanied by inline CT over the femoral region.All of the images were blindly interpreted independently by two experienced board-certified radiologists.The reference standard was follow-up over half a year of MRI,CT,SPECT,or pathology.Diagnoses which consist with reference were counted as accurate.Diagnoses which either not consist with reference or undetermined were counted as false.McNemar test was used for data analysis.Results of the 94 patients,78 patients(male 42,female 36,mean age 62 years) had definite diagnosis;19 were malignant and 59 were benign diseases.The diagnostic accuracy by bone SPECT,bone CT was significantly lower than fusion imaging[58.9%(46/78),87.2%(68/78),96.2%(75/78),respectively,X2=16.48,48.18,both P＜0.05].Conclusions Most of the solitary femoral foei caused by benign diseases.SPECT/CT using 99Tcm-MDP has additional value than with SPECT or CT alone in differentiating malignancy from benignancy in femoral foci.