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目的应用18氟-脱氧葡萄糖(18F-FDG)正电子发射计算机体层摄影(PET)-CT全身显像,探讨PET、同机CT和PET-CT融合图像在骨转移瘤诊断中的价值。方法共332例18F-FDG PET-CT受检者中有35例发现骨异常病变。分别阅读和记录18FDG PET图像、同机CT图像和PET-CT融合图像判断的良、恶性病变,比较3种方法在诊断骨转移瘤上的差异。结果35例中共检出89个病灶,其中68个病灶最后确诊为恶性肿瘤骨转移,21个为良性病变。PET诊断骨转移病灶62个,诊断良性病变17个,诊断骨转移瘤的敏感性为91.2%(62/68个),特异性为81.0%(17/21个),准确性为88.8%(79/89个);同机CT诊断骨转移病灶55个,良性病变16个。诊断骨转移瘤的敏感性、特异性和准确性分别为80.9%(55/68个),76.2%(16/21个)和79.8%(71/89个);PET-CT融合图像诊断骨转移病灶64个,良性病变19个,诊断骨转移瘤的敏感性、特异性和准确性分别为94.1%(64/68个),90.5%(19/21个)和93.2%(83/89个)。结论PET-CT融合图像在诊断骨转移瘤方面,可减少单用PET或单用CT诊断时的假阴性和假阳性,提高了鉴别骨良、恶性病变的能力。
Objective To evaluate the value of 18F-FDG positron emission computed tomography-CT whole body imaging in the diagnosis of bone metastases by PET, CT and PET-CT. Methods A total of 332 cases of 18F-FDG PET-CT in 35 patients found abnormal bone lesions. The 18FDG PET images, CT images and PET-CT fusion images were read and recorded respectively for benign and malignant lesions. The differences between the three methods in the diagnosis of bone metastases were compared. Results A total of 89 lesions were detected in 35 cases, of which 68 were finally diagnosed as malignant bone metastases and 21 were benign lesions. There were 62 lesions of bone metastases diagnosed by PET and 17 of them were diagnosed as benign lesions. The sensitivity of PET was 91.2% (62/68), the specificity was 81.0% (17/21) and the accuracy was 88.8% (79) / 89); the same CT diagnosis of bone metastases in 55 lesions, 16 benign lesions. The sensitivity, specificity and accuracy of the diagnosis of bone metastases were 80.9% (55/68), 76.2% (16/21) and 79.8% (71/89) respectively. The diagnosis of bone metastases There were 64 lesions and 19 benign lesions. The sensitivity, specificity and accuracy of the diagnosis of bone metastases were 94.1% (64/68), 90.5% (19/21) and 93.2% (83/89) respectively. . Conclusions The PET-CT fusion image can reduce the false negative and false positive in the diagnosis of bone metastases with single PET or single CT, and improve the ability of differentiating benign from malignant bone.