摘要
目的：探讨SPECT/螺旋CT融合显像鉴别诊断颅骨良恶性病变的临床价值。方法：对19例恶性肿瘤患者全身骨扫描（WBS）显示颅骨放射性浓聚的21个病灶行SPECT/CT融合显像，由两名有经验的核医学科医生独立阅片。患者同期接受MRI和/或CT检查，各检查时间间隔不超过两周，并对所有病例进行随访，平均随访约9个月，随访结果主要根据随后的影像学检查（MRI、CT或随后的骨扫描）及临床信息。结果：根据同期影像及随访检查共10个病灶诊断为恶性病变，11个病灶诊断为良性病变。SPECT/CT融合显像检出全部10个恶性病灶及8个良性病变，诊断符合率为85.71%。1个病灶在SPECT/CT融合显像中诊断为恶性，而同期MRI及随访检查显示良性病变。另有两个病灶在SPECT/CT中难以确定其性质，同期影像及随访检查亦显示为良性。SPECT/CT融合显像在肯定性诊断为良、恶性病灶中诊断颅骨恶性病变的敏感性、特异性、阳性预测值、阴性预测值分别为100.00%、88.89%、90.91%、100.00%。结论：SPECT/螺旋CT融合显像对鉴别诊断颅骨良恶性病变有较高的敏感性和特异性。
Abstract
Objective: To evaluate the value of single photon emission computed tomography(SPECT)/spiral computed tomography(CT) fusion imaging in the differential diagnosis of benign and malignant skull lesions. Methods: Nineteen cancer patients with 21 skull lesions on whole-body bone scan(WBS) were recruited and underwent SPECT/CT fused imaging of the head. The images were evaluated by two independent reviewers. The patients underwent MRI and/or CT examinations within two weeks after SPECT/CT. An average follow-up interval after SPECT/CT was 9 months to correlate with additional radiologic imaging studies and clinical informations. Results: Ten lesions were classified as metastatic lesions and 11 lesions were classified as benign based on the other radiological examinations performed at the same period and follow-up. The SPECT/CT correctly identified 10 out of 10 metastatic lesions and 8 out of 11 benign lesions, 85.71% of lesions were correctly classified. One lesion was classified incorrectly as metastatic lesion with SPECT/CT while it was proven benign by other imaging modalities and follow-up. Two lesions remained indeterminate even after the SPECT/CT examination and were confirmed benign by other imaging modalities and follow-up. The sensitivity, specificity, positive and negative predictive values of SPECT/CT images in the diagnosis of malignant skull lesions were 100.00%, 88.89%, 90.91% and 100.00%, respectively. Conclusions: SPECT/spiral CT can help identify benign versus metastatic skull lesions with high sensitivity and specificity.
关键词
颅骨肿瘤 /
骨疾病 /
体层摄影术 /
螺旋计算机 /
体层摄影术 /
发射型计算机 /
单光子
Key words
Skull neoplasms /
Bone diseases /
Tomography /
spiral computed /
Tomography /
emission-computer /
single-photon
韩鹏慧;张书旭;葛永兵;任志刚;张国前.
SPECT/螺旋CT融合显像鉴别诊断颅骨良恶性病变的临床价值[J]. 中国临床医学影像杂志. 2012, 23(7): 484-487
HAN Peng-hui;ZHANG Shu-xu;GE Yong-bing;REN Zhi-gang;ZHANG Guo-qian.
The value of single photon emission computed tomography/spiral computed tomography fusion imaging forthe differential diagnosis of benign and malignant skull lesions[J]. Journal of China Clinic Medical Imaging. 2012, 23(7): 484-487
中图分类号：
Ｒ738.1
R681
R817.4
Ｒ814.42
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
