探讨SPECT-CT融合显像在肿瘤骨转移诊断中的增益价值
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摘要
目的:分析单光子发射型电子计算机断层扫描(SPECT)-CT融合显像在肿瘤骨转移诊断中的增益价值。方法:选取81例因不明原因骨痛进行治疗的肿瘤患者,入院后均注射锝99-亚甲基二磷酸盐(~(99)Tc~m-MDP)740～1110 MBp,于注射后3～6 h进行全身骨显像,对发现的可疑病灶进行SPECT-CT融合显像检查,参考显像平面图片对肿瘤骨转移的诊断结果进行分析。结果:SPECT图像与SPECT-CT融合图像诊断结果不确定性对比,SPECT-CT融合图像低于SPECT图像,其差异有统计学意义(x~2=28.116,P<0.05)。在81例患者中肿瘤骨转移为33例,无肿瘤骨转移48例,SPECT-CT融合图像明确诊断77例(95.06%),显著高于SPECT图像44例(54.32%),其差异有统计学意义(x~2=43.899,P<0.05)。结论:针对肿瘤骨转移临床诊断时,SPECT-CT融合显像的使用与SPECT显像相比较,可有效提高疾病进展的鉴别能力与骨转移情况的确诊率。
Objective:To analyze the gain value of single-photon emission computed tomography(SPECT/CT)fusion imaging in diagnosis on osseous metastasis of tumor.Methods:81 patients with cancer,who had unexplained bone pain and were implemented treatment,were selected.All of patients were injected with ~(99)Tc~m-MDP 740-1110MBp after they were admitted to hospital.All of them underwent osseous imaging of whole body at 3-6h post injection,and then the suspected lesions of them were implemented SPECT-CT fusion examination.And the planar photograph of imaging was used as reference to analyze the diagnostic results for osseous metastasis of tumor.Results:As the comparison of indeterminacy of diagnostic results of SPECT imaging and SPECT-CT fusion imaging,SPECT-CT fusion imaging was significantly lower than SPECT imaging(x~2=28.116,P<0.05).In 81 patients,the osseous metastasis of tumor was found in 33 cases,and other 48cases didn't have that.The definite diagnostic rate of SPECT-CT fusion images(95.06%,77 cases)was significantly higher than that of SPECT images(54.32%,44 cases)(x~2=43.899,P<0.05).Conclusion:For the clinical diagnosis of osseous metastasis of tumor,the use of SPECT/CT fusion imaging can effectively enhance the identification ability of progression of disease and the confirmed diagnostic rate of osseous metastasis compared with SPECT imaging.
Objective:To analyze the gain value of single-photon emission computed tomography(SPECT/CT)fusion imaging in diagnosis on osseous metastasis of tumor.Methods:81 patients with cancer,who had unexplained bone pain and were implemented treatment,were selected.All of patients were injected with ~(99)Tc~m-MDP 740-1110MBp after they were admitted to hospital.All of them underwent osseous imaging of whole body at 3-6h post injection,and then the suspected lesions of them were implemented SPECT-CT fusion examination.And the planar photograph of imaging was used as reference to analyze the diagnostic results for osseous metastasis of tumor.Results:As the comparison of indeterminacy of diagnostic results of SPECT imaging and SPECT-CT fusion imaging,SPECT-CT fusion imaging was significantly lower than SPECT imaging(x~2=28.116,P<0.05).In 81 patients,the osseous metastasis of tumor was found in 33 cases,and other 48cases didn't have that.The definite diagnostic rate of SPECT-CT fusion images(95.06%,77 cases)was significantly higher than that of SPECT images(54.32%,44 cases)(x~2=43.899,P<0.05).Conclusion:For the clinical diagnosis of osseous metastasis of tumor,the use of SPECT/CT fusion imaging can effectively enhance the identification ability of progression of disease and the confirmed diagnostic rate of osseous metastasis compared with SPECT imaging.
引文
[1]余颂科,陈晓良,蒋世曦.99Tcm-MDP SPECT/CT图像融合对非典型骨转移肿瘤的诊断价值[J].检验医学与临床,2016,13(7):876-877.
[2]Jin X,Liang N,Wang M,et al.Integrin Imaging with 99Tcm-3PRGD2 SPECT/CT Shows High Specificity in the Diagnosis of Lymph Node Metastasis from Non-Small Cell Lung Cancer[J].Radiology,2016,281(3):958-966.
[3]张林启,覃艺芳,李伟,等.常规SPECT/CT断层融合显像诊断高危前列腺癌患者骨转移[J].中国医学影像技术,2017,33(2):260-264.
[4]张雪辉.SPECT/CT同机融合显像对脊柱单发病变的鉴别诊断价值[J].肿瘤学杂志,2017,23(10):890-894.
[5]张斌青,刘云,张敏,等.SPECT/CT融合显像对腰椎峡部裂的诊断增益价值[J].中国临床医学影像杂志,2017,28(3):216-219.
[6]Ogata Y,Nakahara T,Ode K,et al.3D SPECT/CT fusion using image data projection of bone SPECT onto 3D volume-rendered CT images:feasibility and clinical impact in the diagnosis of bone metastasis[J].Annals of Nuclear Medicine,2017,31(4):304-314.
[7]张若,刘玉婷,金刚.99Tcm-MIBI SPECT/CT同机融合显像在肿瘤诊断中的临床价值[J].标记免疫分析与临床,2017,24(10):1193-1196.
[8]王东,孟宪平,陈则君,等.SPECT/CT融合图像与全身骨显像对骨转移瘤诊断的价值分析[J].中国CT和MRI杂志,2016,14(4):126-129.
[9]魏强,邱刚,房保栓,等.SPECT/CT融合显像与WB-DWI成像对骨转移瘤诊断价值比较[J].现代中西医结合杂志,2016,25(30):3401-3404.
[10]刘嘉辰,林笑丰,李敬彦,等.99Tcm-MDP SPECT/CT融合骨显像在恶性肿瘤骨转移诊断和治疗决策中的作用[J].实用医学杂志,2017,33(8):1331-1334.
[11]翟士军,张玉娜,米宝明,等.SPECT/CT融合骨显像对乳腺癌骨转移的诊断价值[J].中国辐射卫生,2016,25(6):746-748.
[12]张树龙,战雷.分化型甲状腺癌131I治疗前99TcmO4-SPECT/CT显像的临床意义[J].中国当代医药,2017,24(1):122-124,131.
[13]钟箫,欧晓红,李林,等.99Tcm-MIBI SPECT/CT融合显像在甲状旁腺功能亢进症术前诊断中的应用价值[J].中华核医学与分子影像杂志,2017,37(7):395-399.
[14]青春,罗毅.SPECT/CT同机融合显像鉴别诊断骶髂关节区单发病变的价值[J].中国临床医学影像杂志,2016,27(3):202-204.
[15]黎俊,李莉,林华.99Tcm-MIBI双时相显像与SPECT/CT融合显像对原发性甲状旁腺功能亢进症的诊断价值[J].医学影像学杂志,2017,27(6):1063-1067.
[2]Jin X,Liang N,Wang M,et al.Integrin Imaging with 99Tcm-3PRGD2 SPECT/CT Shows High Specificity in the Diagnosis of Lymph Node Metastasis from Non-Small Cell Lung Cancer[J].Radiology,2016,281(3):958-966.
[3]张林启,覃艺芳,李伟,等.常规SPECT/CT断层融合显像诊断高危前列腺癌患者骨转移[J].中国医学影像技术,2017,33(2):260-264.
[4]张雪辉.SPECT/CT同机融合显像对脊柱单发病变的鉴别诊断价值[J].肿瘤学杂志,2017,23(10):890-894.
[5]张斌青,刘云,张敏,等.SPECT/CT融合显像对腰椎峡部裂的诊断增益价值[J].中国临床医学影像杂志,2017,28(3):216-219.
[6]Ogata Y,Nakahara T,Ode K,et al.3D SPECT/CT fusion using image data projection of bone SPECT onto 3D volume-rendered CT images:feasibility and clinical impact in the diagnosis of bone metastasis[J].Annals of Nuclear Medicine,2017,31(4):304-314.
[7]张若,刘玉婷,金刚.99Tcm-MIBI SPECT/CT同机融合显像在肿瘤诊断中的临床价值[J].标记免疫分析与临床,2017,24(10):1193-1196.
[8]王东,孟宪平,陈则君,等.SPECT/CT融合图像与全身骨显像对骨转移瘤诊断的价值分析[J].中国CT和MRI杂志,2016,14(4):126-129.
[9]魏强,邱刚,房保栓,等.SPECT/CT融合显像与WB-DWI成像对骨转移瘤诊断价值比较[J].现代中西医结合杂志,2016,25(30):3401-3404.
[10]刘嘉辰,林笑丰,李敬彦,等.99Tcm-MDP SPECT/CT融合骨显像在恶性肿瘤骨转移诊断和治疗决策中的作用[J].实用医学杂志,2017,33(8):1331-1334.
[11]翟士军,张玉娜,米宝明,等.SPECT/CT融合骨显像对乳腺癌骨转移的诊断价值[J].中国辐射卫生,2016,25(6):746-748.
[12]张树龙,战雷.分化型甲状腺癌131I治疗前99TcmO4-SPECT/CT显像的临床意义[J].中国当代医药,2017,24(1):122-124,131.
[13]钟箫,欧晓红,李林,等.99Tcm-MIBI SPECT/CT融合显像在甲状旁腺功能亢进症术前诊断中的应用价值[J].中华核医学与分子影像杂志,2017,37(7):395-399.
[14]青春,罗毅.SPECT/CT同机融合显像鉴别诊断骶髂关节区单发病变的价值[J].中国临床医学影像杂志,2016,27(3):202-204.
[15]黎俊,李莉,林华.99Tcm-MIBI双时相显像与SPECT/CT融合显像对原发性甲状旁腺功能亢进症的诊断价值[J].医学影像学杂志,2017,27(6):1063-1067.