单光子发射计算机断层成像术/计算机断层成像融合显像在脊柱单发病灶诊断及良恶性鉴别中的应用

摘要

目的 探讨单光子发射计算机断层成像术/计算机断层成像(SPECT/CT)融合显像在脊柱单发病灶诊断及良恶性鉴别中的应用价值.方法 选取山西省肿瘤医院核医学科2016年3月至2017年1月经病理证实存在骨外恶性肿瘤、全身骨显像发现脊柱单发病灶的患者86例,患者均加做了该部位SPECT/CT融合显像.以病理学检查结果或大于6个月多种影像学检查及临床随访情况为最终诊断依据,对SPECT及SPECT/CT诊断效能进行分析对比.结果 SPECT/CT融合显像诊断脊柱单发病灶的敏感度、特异度、阳性预测值、阴性预测值、假阳性率、假阴性率分别为93.9％、75.7％、83.6％、90.3％、24.3％、6.1％,SPECT以上指标分别为93.9％、37.8％、66.7％、82.4％、62.2％、6.1％.SPECT/CT对脊柱单发病灶的诊断效能高于SPECT,差异有统计学意义(x2=6.72,P＜0.01).结论 SPECT/CT融合显像提高了脊柱单发病灶的诊断准确率,在良恶性鉴别诊断中具有明显的增益价值.%Objective To analyze the value of single-photon emission computed tomography/computerized tomography(SPECT/CT) in diagnosis and differential diagnosis of benign and malignant spinal tumors.Methods A total of 86 patients with single spinal extraosseous malignant tumor diagnosed by physiological test and bone imaging in Shanxi Provincial Cancer Hospital from March 2016 to January 2017 were enrolled.All patients had SPECT/CT examination.Final diagnosis was confirmed by pathological results,combined imaging results and follow-up(≥ 6 months) data.Diagnostic efficiency of SPECT/CT was analyzed in comparison with SPECT.Results Sensitivity,specificity,positive predictive value,negative predictive value,false positive rate and false negative rate of SPECT/CT in diagnosis of single spinal lesion were 93.9％,75.7％,83.6％,90.3％,24.3％ and 6.1％.Sensitivity,specificity,positive predictive value,negative predictive value,false positive rate and false negative rate of SPECT in diagnosis of single spinal lesion were 93.9％,37.8％,66.7％,82.4％,62.2％ and 6.1％.The diagnostic efficiency of SPECT/CT was higher than that of SPECT (x2 =6.72,P ＜ 0.01).Conclusion SPECT/CT shows high accuracy and great reliability in diagnosis of single spinal tumor and differential diagnosis of benign and malignant spinal lesions.