CAJ | 학술논문

目的评价SPECT/CT融合显像对99Tcm-MDP全身骨显像难于确诊的乳腺癌骨病灶的鉴别诊断价值.方法对99Tcm-MDP全身骨显像难于确诊的132例乳腺癌患者的210个病灶行局部SPECT/CT同机融合断层显像,以临床随访及病理检查获得最终诊断结果,计算SPECT/CT融合显像对骨转移灶的诊断准确率、灵敏度、特异度、阳性预测值及阴性预测值,并对比不同部位病灶的诊断准确率差异.结果 ①210个病灶经SPECT/CT融合断层显像正确诊断的恶性病灶82个(39.0％),良性病灶112个(53.3％),诊断准确率为92.4％(194/210),灵敏度为94.3％,特异度为91.1％,阳性预测值为88.2％,阴性预测值为95.7％.②SPECT/CT同机融合断层显像对不同部位的病灶的诊断准确率不一致,脊椎的诊断准确率最高,为95.9％(94/97),肋骨最低,为83.7％(36/43),其差异有统计学意义(x2=7.81,P＜0.05).结论 SPECT/CT同机融合显像能够对~Tcm-MDP全身骨显像难于确诊的病灶进行准确诊断,其对不同部位的病灶的诊断准确率有差异,脊椎的诊断准确率最高,肋骨最低.
목적 평개SPECT/CT융합현상대99Tcm-MDP전신골현상난우학진적유선암골병조적감별진단개치.방법 대99Tcm-MDP전신골현상난우학진적132례유선암환자적210개병조행국부SPECT/CT동궤융합단층현상,이림상수방급병리검사획득최종진단결과,계산SPECT/CT융합현상대골전이조적진단준학솔、령민도、특이도、양성예측치급음성예측치,병대비불동부위병조적진단준학솔차이.결과 ①210개병조경SPECT/CT융합단층현상정학진단적악성병조82개(39.0％),량성병조112개(53.3％),진단준학솔위92.4％(194/210),령민도위94.3％,특이도위91.1％,양성예측치위88.2％,음성예측치위95.7％.②SPECT/CT동궤융합단층현상대불동부위적병조적진단준학솔불일치,척추적진단준학솔최고,위95.9％(94/97),륵골최저,위83.7％(36/43),기차이유통계학의의(x2=7.81,P＜0.05).결론 SPECT/CT동궤융합현상능구대~Tcm-MDP전신골현상난우학진적병조진행준학진단,기대불동부위적병조적진단준학솔유차이,척추적진단준학솔최고,륵골최저.
Objective To evaluate the diagnostic value of SPECT/CT fusion imaging in indeter-minate lesions on 99Tcm-MDP whole-body bone scan in patients with breast cancer.Methods 210 bone lesions of 132 patients with breast cancer,for whom the natures of the lesions were unable to be determined by the 99xTcm-MDP whole-body bone scan,were examined by the SPECT/CT fusion imaging simultaneously.The natures of the lesions were eventually confirmed by pathology and clinical follow-up.The accuracy,sensitivity,specificity,positive predictive value and negative predictive value of SPECT/CT fusion imaging for diagnosing bone-metastases were calculated.In addition,the diagnostic accuracy of SPECT/CT fusion imaging for bone lesions in various parts of the body was also analyzed.Results ①Of 210 bone lesions,82 of bone metastases and 112 benign bone lesions were correctly diagnosed by SPECT/CT fusion imaging.The diagnostic accuracy,sensitivity,specificity,positive prediction value and negative prediction value was 92.4％ (194/210),94.3％ (82/87),91.1％ (112/123),88.2％ (82/93),95.7％ (112/117),respectively.②The diagnostic accuracy of 99Tcm-MDP SPECT/CT for spinal bone lesions were significantly higher than that for rib lesions (95.9％ versus 83.7％,x2=7.81,P＜0.05).Conclusions ①92.4％ bone lesions in patients with breast cancer,which can not determined on 99Tcm-MDP whole-body bone scan,can be diagnosed by SPECT/CT fusion imaging accurately.②Diagnositic compliance rate of SPECT/CT fusion imaging is different in different parts with obscure lesion,which is the highest in the spine,the minimum in ribs.