CAJ | 학술논문

目的探讨双探头带符合线路18F-脱氧葡萄糖(FDG)显像和99Tcm-亚甲基二磷酸盐(MDP)骨显像对肺癌骨转移瘤的诊断价值.资料与方法38例经病理证实的肺癌患者于2周内分别行18F-FDG 符合显像和99Tcm-MDP 骨显像.比较两种显像方式对两侧肩关节、脊柱、肋骨和骨盆骨转移灶检出的敏感性、特异性及准确性.最终骨转移瘤诊断标准由手术病理、CT/MR 检查或临床随访半年以上范围扩大证实.结果根据骨转移的最终标准,38例患者共158处骨转移病灶,18F-FDG 检出119个,99Tcm-MDP 骨显像检出142个.18F-FDG与99Tcm-MDP 骨显像探测骨转移的敏感性、特异性及准确性分别为65.8%、84.2%、72.7%,78.5%、81.1%、79.4%.99Tcm-MDP 骨显像对骨转移灶的诊断敏感性高于18F-FDG,差异有统计学意义(χ2=6.30, P<0.05),但特异性和准确性差异均无统计学意义(χ2=0.33、3.14, P>0.05).结论99Tcm-MDP 骨显像检测肺癌骨转移灶具有较高的敏感性,18F-FDG 符合线路显像对诊断骨转移灶有一定帮助,两者联合可以提高肺癌骨转移的诊断.
목적탐토쌍탐두대부합선로18F-탈양포도당(FDG)현상화99Tcm-아갑기이린산염(MDP)골현상대폐암골전이류적진단개치.자료여방법38례경병리증실적폐암환자우2주내분별행18F-FDG 부합현상화99Tcm-MDP 골현상.비교량충현상방식대량측견관절、척주、륵골화골분골전이조검출적민감성、특이성급준학성.최종골전이류진단표준유수술병리、CT/MR 검사혹림상수방반년이상범위확대증실.결과근거골전이적최종표준,38례환자공158처골전이병조,18F-FDG 검출119개,99Tcm-MDP 골현상검출142개.18F-FDG여99Tcm-MDP 골현상탐측골전이적민감성、특이성급준학성분별위65.8%、84.2%、72.7%,78.5%、81.1%、79.4%.99Tcm-MDP 골현상대골전이조적진단민감성고우18F-FDG,차이유통계학의의(χ2=6.30, P<0.05),단특이성화준학성차이균무통계학의의(χ2=0.33、3.14, P>0.05).결론99Tcm-MDP 골현상검측폐암골전이조구유교고적민감성,18F-FDG 부합선로현상대진단골전이조유일정방조,량자연합가이제고폐암골전이적진단.
Purpose To investigate the value of 18F-fluorodeoxyglucose (FDG) coincidence imaging and 99Tcm-methylene diphosphonate (MDP) bone scan in diagnosing lung cancer with bone metastases. Materials and Methods Thirty-eight patients with pathology proven lung cancer underwent whole body 99Tcm-MDP bone scan and 18F-FDG coincidence imaging within two weeks. The sensitivity, specificity and accuracy of two methods in detecting bone metastasis in the bilateral shoulder joints, vertebral column, ribs and pelvis were compared. Results 158 metastatic bone lesions were found in 38 patients with lung cancer. Of the 158 lesions proved by ultimate bone metastatic criteria, 119 were found on 18F-FDG imaging, 142 metastatic lesions were found on 99Tcm-MDP bone scan. The sensitivity, specificity and accuracy of 18F-FDG and 99Tcm-MDP were 65.8%, 84.2%, 72.7%; and 78.5%, 81.1%, 79.4%, respectively. The specificity and accuracy were not statistically different (χ2=0.33, 3.14, P>0.05), but the sensitivity of 99Tcm-MDP bone scan was higher than that of 18F-FDG (χ2=6.30, P < 0.05). Conclusion 99Tcm-MDP bone scan is more sensitive in detecting bone metastasis in lung cancer. 18F-FDG coincidence imaging can help diagnose bone metastases. Combining the two methods improves diagnosis of bone metastasis.