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目的 探讨脊柱结核的18 F-FDG PET/CT征象.方法 回顾性分析2006年1月至2014年6月间有椎体溶骨性或混合性骨质破坏的125例患者的18 F-FDG PET/CT资料,男70例,女55例,平均年龄44.3岁,其中研究组(脊柱结核)32例,50个病灶,对照组(其他疾病)93例,150个病灶.采用二分类logistic回归逐步向前LR法,筛选出对诊断脊柱结核有统计学意义的PET/CT征象,并计算这些征象及其组合诊断脊柱结核的灵敏度及特异性.结果 18F-FDG PET/CT诊断脊柱结核有统计学意义的征象优势比由高到低分别为:椎旁“冷脓肿”(优势比20.790)、存在放射性“冷区”(10.528)、椎间盘病变(5.394)、连续椎体受累(3.493),其灵敏度、特异性分别为22.0％ (11/50)、99.3％(149/150),70.0％ (35/50)、90.0％(135/150),82.0％ (41/50)、83.0％(125/150),82.0％(41/50)、78.0％(117/150).脊柱结核多出现2种及以上的征象,“连续椎体受累+椎间盘病变”最多见,其诊断脊柱结核的灵敏度、特异性分别为78.0％ (39/50)和88.7％(133/150),“连续椎体受累+椎间盘病变+存在放射性‘冷区’”的灵敏度、特异性分别为58.0％ (29/50)和96.0％ (144/150),4种征象同时出现对应的灵敏度、特异性分别为14.0％ (7/50)和100％(150/150).结论 回归分析表明,18F-FDG PET/CT诊断脊柱结核有统计学意义的征象为:椎旁“冷脓肿”、存在放射性“冷区”、椎间盘病变、连续椎体受累,多数征象及其组合对诊断脊柱结核有较高的灵敏度及特异性.“,”Objective To investigate the diagnostic value of 18F-FDG PET/CT features of spinal tuberculosis.Methods 18 F-FDG PET/CT imaging manifestation of 125 cases (70 males,55 females,average age 44.3 years) with osseous or mixed vertebra bone destruction from January 2006 to June 2014 were analyzed retrospectively.The patients included 32 cases with spinal tuberculosis (50 lesions,study group) and 93 cases with other diseases (150 lesions,control group).The corresponding FDG PET/CT features were analyzed by two classification logistic regression (Forward:LR),then FDG PET/CT features with statistical significance in diagnosis of spinal tuberculosis were obtained.The sensitivity and specificity of those FDG PET/CT features were calculated.Results Odds ratio (OR) of FDG PET/CT features with statistical significance in diagnosis of spinal tuberculosis from high to low were paraspinal “cold abscess” (20.790),“cold zone”(10.528),intervertebral disc involvement(5.394),continuous vertebral involvement(3.493).The diagnostic sensitivity and specificity were 22.0％ (11/50),99.3％ (149/150) for “ cold abscess”,70.0％ (35/50),90.0％ (135/150) for “cold zone”,82.0％ (41/50),83.0％ (125/150) for intervertebral disc involvement,82.0％ (41/50),78.0％ (117/150) for continuous vertebral involvement,respectively.Spinal tuberculosis often had two or more signs.The “continuous vertebral involvement + intervertebral disc involvement” was most common,with the diagnostic sensitivity and specificity of 78.0％ (39/50) and 88.7％ (133/150).The diagnostic sensitivity and specificity of “continuous vertebral involvement+intervertebral disc involvement+cold zone” were 58.0％ (29/50),96.0％ (144/150),and those of four features conourrence were 14.0％ (7/50),100％ (150/150),respectively.Conclusion Regression analysis shows that FDG PET/CT features with statistical significance in diagnosis of spinal tuberculosis are paraspinal “cold abscess”,“cold zone”,intervertebral disc involvement,continuous vertebral involvement,which have high diagnostic sensitivity and specificity.