SPECT/CT融合骨显像对乳腺癌骨转移的诊断价值

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目的探讨SPECT/CT融合骨显像对乳腺癌骨转移的诊断价值。方法 96例乳腺癌可疑骨转移的患者,静脉注射~(99)mTc-MDP 740~1110 MBq,3~6 h后按常规方法行SPECT全身骨显像,对发现的可疑病灶行SPECT/CT融合显像。由两位核医学科医师先对全身骨显像的平面图像进行分析,然后分析SPECT/CT融合图像并诊断,诊断分为肿瘤骨转移和无骨转移。诊断结果分别与病理或随访获得的正确诊断比较,并计算全身骨显像、SPECT/CT融合显像对患者诊断的灵敏度、特异性及符合率,采用SPSS 16.0软件,对全身平面显像和SPECT/CT融合显像两组数据的差异进行χ~2检验,P<0.05为差异有统计学意义。结果 96例乳腺癌患者最终诊断为骨转移者53例,无肿瘤骨转移者43例。全身骨显像诊断肿瘤骨转移40例,灵敏度为75.5%(40/53),无肿瘤骨转移28例,特异性为65.1%(28/43),全身骨显像诊断与最终诊断结果符合68例,诊断符合率为70.8%(68/96);SPECT/CT融合骨显像诊断的灵敏度为94.3%(50/53),特异性为95.3%(41/43),诊断符合率为94.8%(91/96),SPECT/CT融合显像诊断的灵敏度、特异性及符合率均明显高于全身平面显像诊断,差异有统计学意义(χ~2=7.36、12.39、19.36,P均<0.05)。结论 SPECT/CT融合骨显像能够提供明确的定位、定性诊断,在乳腺癌骨转移诊断中较全身骨显像有更大的临床应用价值。 Objective To investigate the diagnostic value of SPECT / CT fusion bone imaging in the diagnosis of bone metastasis of breast cancer. Methods Ninety-six patients with suspicious bone metastases from breast cancer were injected with ~ (99) mTc-MDP 740 ~ 1110 MBq intravenously. SPECT / CT fusion was performed on the suspected lesions after 3 ~ 6 h according to the conventional method. Imaging. Two nuclear medicine physicians first analyzed the whole body image of the bone imaging plane, and then analyzed SPECT / CT fusion images and diagnosis, diagnosis of tumor bone metastasis and bone metastasis. The diagnostic results were compared with the correct diagnosis of the pathology or follow-up, and the sensitivity, specificity and coincidence rate of the whole body bone imaging and SPECT / CT fusion imaging were calculated. Using SPSS 16.0 software, / CT fusion imaging two sets of data differences χ ~ 2 test, P <0.05 for the difference was statistically significant. Results 96 cases of breast cancer patients eventually diagnosed as bone metastases in 53 cases, no tumor bone metastases in 43 cases. There were 40 cases with bone metastasis diagnosed by whole body bone imaging with sensitivity of 75.5% (40/53), 28 cases without tumor bone metastasis, and the specificity was 65.1% (28/43). The results of whole body bone imaging and final diagnosis were in line with 68 The diagnostic accuracy rate was 70.8% (68/96). The sensitivity and specificity of SPECT / CT fusion imaging were 94.3% (50/53) and 95.3% (41/43), respectively. The diagnostic coincidence rate was 94.8% (91/96). The sensitivity, specificity and coincidence rate of SPECT / CT fusion imaging were significantly higher than that of whole body plain imaging (χ ~ 2 = 7.36,12.39,19.36, P < 0.05). Conclusion SPECT / CT fusion bone imaging can provide definite localization and qualitative diagnosis. It has more clinical value in diagnosis of bone metastasis of breast cancer than whole body bone imaging.
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