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
2013年
4期
221-224
,共4页
樊孝廉%鲁胜男%古炎发%张爱芳
樊孝廉%魯勝男%古炎髮%張愛芳
번효렴%로성남%고염발%장애방
乳腺肿瘤%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
乳腺腫瘤%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
유선종류%종류전이%체층섭영술,발사형계산궤,단광자%체층섭영술,X선계산궤
Breast neoplasms%Neoplasms metastasis%Tomography,emission-computed,singlephoton%Tomography,X-ray computed
目的 探讨SPECT/CT融合显像诊断与鉴别乳腺癌患者全身骨显像放射性异常浓聚灶的临床价值.方法 对25例乳腺癌患者的99Tcm-MDP全身骨显像显示的骨异常放射性浓聚灶行SPECT/CT融合显像.4～8个月后再次行全身骨显像及SPECT/CT融合显像复查.图像由两名有经验的核医学科医师独立分析,部分CT图像由有经验的放射科医师分析指导.结果 在25例乳腺癌患者的37个异常放射性浓聚灶中,确定29 (29/37,78.38％)个病灶为骨转移灶,其中有2个椎体病灶在初次检查中判读为良性病灶；8(8/37,21.62％)个病灶为良性病灶,其中1个肋骨病灶在初次检查中判读为骨转移灶,比较全身骨显像和SPECT/CT融合显像,二者之间差异有统计学意义(x2=6.975,P＜0.05).骨转移灶主要分布于椎骨及肋骨.全身骨显像和SPECT/CT融合显像的诊断灵敏度、特异度、阳性预测值、阴性预测值和准确率分别为82.76％、75.00％、92.31％、54.55％、81.08％和93.10％、87.50％、96.43％、77.78％、91.89％.采用受试者操作特性曲线(ROC)进行分析,结果:全身骨显像曲线下面积为0.860±0.056,SPECT/CT融合显像曲线下面积为0.974±0.020.SPECT/CT融合显像曲线下面积大于全身骨显像曲线下面积,两者之间差异具有统计学意义(x2=9.924,P＜0.001).结论 SPECT/CT融合显像较全身骨显像能更好地鉴别出乳腺癌骨病灶的性质,能够提高诊断准确率,具有重要的临床价值；必要时应在4～8个月后复查SPECT/CT.
目的 探討SPECT/CT融閤顯像診斷與鑒彆乳腺癌患者全身骨顯像放射性異常濃聚竈的臨床價值.方法 對25例乳腺癌患者的99Tcm-MDP全身骨顯像顯示的骨異常放射性濃聚竈行SPECT/CT融閤顯像.4～8箇月後再次行全身骨顯像及SPECT/CT融閤顯像複查.圖像由兩名有經驗的覈醫學科醫師獨立分析,部分CT圖像由有經驗的放射科醫師分析指導.結果 在25例乳腺癌患者的37箇異常放射性濃聚竈中,確定29 (29/37,78.38％)箇病竈為骨轉移竈,其中有2箇椎體病竈在初次檢查中判讀為良性病竈；8(8/37,21.62％)箇病竈為良性病竈,其中1箇肋骨病竈在初次檢查中判讀為骨轉移竈,比較全身骨顯像和SPECT/CT融閤顯像,二者之間差異有統計學意義(x2=6.975,P＜0.05).骨轉移竈主要分佈于椎骨及肋骨.全身骨顯像和SPECT/CT融閤顯像的診斷靈敏度、特異度、暘性預測值、陰性預測值和準確率分彆為82.76％、75.00％、92.31％、54.55％、81.08％和93.10％、87.50％、96.43％、77.78％、91.89％.採用受試者操作特性麯線(ROC)進行分析,結果:全身骨顯像麯線下麵積為0.860±0.056,SPECT/CT融閤顯像麯線下麵積為0.974±0.020.SPECT/CT融閤顯像麯線下麵積大于全身骨顯像麯線下麵積,兩者之間差異具有統計學意義(x2=9.924,P＜0.001).結論 SPECT/CT融閤顯像較全身骨顯像能更好地鑒彆齣乳腺癌骨病竈的性質,能夠提高診斷準確率,具有重要的臨床價值；必要時應在4～8箇月後複查SPECT/CT.
목적 탐토SPECT/CT융합현상진단여감별유선암환자전신골현상방사성이상농취조적림상개치.방법 대25례유선암환자적99Tcm-MDP전신골현상현시적골이상방사성농취조행SPECT/CT융합현상.4～8개월후재차행전신골현상급SPECT/CT융합현상복사.도상유량명유경험적핵의학과의사독립분석,부분CT도상유유경험적방사과의사분석지도.결과 재25례유선암환자적37개이상방사성농취조중,학정29 (29/37,78.38％)개병조위골전이조,기중유2개추체병조재초차검사중판독위량성병조；8(8/37,21.62％)개병조위량성병조,기중1개륵골병조재초차검사중판독위골전이조,비교전신골현상화SPECT/CT융합현상,이자지간차이유통계학의의(x2=6.975,P＜0.05).골전이조주요분포우추골급륵골.전신골현상화SPECT/CT융합현상적진단령민도、특이도、양성예측치、음성예측치화준학솔분별위82.76％、75.00％、92.31％、54.55％、81.08％화93.10％、87.50％、96.43％、77.78％、91.89％.채용수시자조작특성곡선(ROC)진행분석,결과:전신골현상곡선하면적위0.860±0.056,SPECT/CT융합현상곡선하면적위0.974±0.020.SPECT/CT융합현상곡선하면적대우전신골현상곡선하면적,량자지간차이구유통계학의의(x2=9.924,P＜0.001).결론 SPECT/CT융합현상교전신골현상능경호지감별출유선암골병조적성질,능구제고진단준학솔,구유중요적림상개치；필요시응재4～8개월후복사SPECT/CT.
Objective To evaluate the clinical value of SPECT/CT fusion imaging in the diagnosis and differential diagnosis the characteristic of the whole body bone scan radioactive hot lesions in patients with breast cancer.Methods The abnormal radioactive hot lesions of whole body bone scan in 25 patients with breast cancer underwent SPECT/CT fusion imaging immediately.Another whole body bone scan and SPECT/CT fusion imaging were carried out 4 to 8 months later in all these patients.The whole body bone scan images,SPECT/CT images and fusion images were analyzed independently by two experienced nuclear medicine physicians and some of the equivocal CT images were analyzed by an experienced radiologist.Results Among all the 37 abnormal radioactive hot bone lesions,29 (29/37,78.38％) lesions were confirmed metastatic lesions,including 2 vertebral lesions classified as benign lesions on the basis of the first examinations data; and 8 lesions were benign,including a rib lesion classified as benign lesion according to the first examinations data.The difference between whole body bone scan and SPECT/CT examination was statistically significant (x2=6.975,P＜0.05).The bone metastases are located mainly in spine and ribs.The sensitivity,specificity,positive and negative predictive values,and accuracy of whole-body bone scan and SPECT/CT fusion imaging were 82.76％,75.00％,92.31％,54.55％,81.08％ and 93.10％,87.50％,96.43％,77.78％,91.89％,respectively.The area under the receiver operating characteristics curve was 0.860±0.056for whole body bone scan and 0.974±0.020 for SPECT/CT.The area under the curve for SPECT/CT was significantly larger compared with the whole body bone scan (x2=9.924,P＜0.001).Conclusions SPECT/CT fusion imaging is better than whole body bone scan alone to characterize the abnormal bone radioactive hot lesions and it can improve the accuracy of diagnosis.The patients should repeat the modality 4 to 8 months later if necessary.
