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【目的】通过SPECT／CT融合显像，对脊柱转移性骨肿瘤精确定位，并与骨质增生性病变鉴别。【方法】收集本科100例有明确恶性肿瘤病史的SPECT／CT融合显像，均显示脊柱不同部位单个异常放射性浓聚灶，对病灶进行定位、定性的统计。【结果】对100例SPECT／CT 融合显像统计，显示脊柱骨质破坏性病变77例，占77％，骨质增生性病变23例，占23％。其中，椎体骨质破坏43例，占43％，椎弓骨质破坏30例，占30％，椎小关节骨质破坏3例，占3％，横突骨质破坏1例（占1％）；椎体骨质增生8例（占8％），椎弓骨质增生2例（占2％），椎小关节骨质增生10例（占10％），横突骨质增生3例（占3％）。SPECT／CT 99m Tc‐MDP骨显像的脊柱单发病灶诊断骨转移性肿瘤的灵敏度为97．4％，特异性为86．9％，阳性似然比为7．43，阴性似然比为0．029，阳性预测值为0．961，阴性预测值为0．909。【结论】有明确恶性肿瘤病史的患者，SPECT 全身骨显像显示脊柱异常放射性浓聚，可通过SPECT／CT融合显像，对转移性骨肿瘤精确定位，并与骨质增生性病变鉴别，大大提高SPECT核素骨显像的诊断准确性。“,”[Objective] To locate the metastatic spinal bone tumors accurately and distinguish from hyper‐osteogeny by SPECT/CT fusion imaging .[Methods] A total of 100 patients with SPECT/CT fusion imaging were collected .They had an explicit history of malignancy in different spinal parts .All single abnormal radio‐activity concentration aggregations were positioned and qualitatively analyzed .[Results]There were 77 spinal bone destructive lesions (77% ) and 23 cases of hyperosteogeny (23% ) .Bone destruction was located in verte‐bral body ( n = 43 ,43% ) ,vertebral arch ( n = 30 ,30% ) ,ridge rib‐joint ( n = 3 ,3% ) and transverse process ( n=1 ,1% ) .There were vertebral body bone hyperplasia ( n=8 ,8% ) ,vertebral arch bone hyper‐plasia ( n=2 ,5% ) ,facet bone hyperplasia ( n=10 ,10% ) and transverse process bone hyperplasia ( n=3 , 3% ) .The sensitivity and specificity of metastatic bone tumor as diagnosed by SPECT/CT 99m Tc‐MDP bone imaging were 97 .4% and 86 .9% respectively .Correspondingly ,the positive likelihood ratio was 7 .43 ,nega‐tive likelihood ratio 0 .029 ,positive predictive value 0 .961 and negative predictive value 0 .909 .[Conclusion]Abnormal radioactivity concentration aggregations are present in patients with an explicit history of malignancy by SPECT whole‐body bone imaging .The diagnostic accuracy of nuclide bone imaging has been greatly en‐hanced .And it allows a precise localization of metastatic bone tumors and aids in differentiating from hyperos‐teogeny .