CT联合全身骨显像在骨转移瘤中的诊断价值

摘要

Objective:To investigate the diagnostic values of CT combined with whole body bone imaging in detec-ting bone metastases.Methods:The data of 212 patients who had positive lesions on the whole body bone imaging,at the same time had CT scan over the same site and with a history of primary tumors were retrospectively analyzed from January 2013 to December 2015.Patients were divided into single and multiple lesions (with two and above)accord-ing to the number of accumulated focus.Diagnostic value of CT,the whole body bone imaging technology and the com-bined method were respectively studied on the basis of pathological diagnosis or clinical follow-up.With matching Chi-square (or correction Chi-square)test comparing the correct diagnostic rate and with the statistical software drawing ROC curve of CT,the whole body bone imaging and the combined method in single and multiple bone metas-tases.Results:212 patients who were confirmed by pathology or clinical follow-up were included in this study,inclu-ding 91 cases with single accumulated focus,121 cases with multiple accumulated focus.CT,the whole body bone im-aging compared with the combined method had statistical differences in the diagnosis of single and multiple bone me-tastases(P<0.05).Area under the ROC curve of the combined method was higher than single whole body bone ima-ging or CT in the diagnosis of single and multiple bone metastases.Conclusion:CT combined with the whole body bone imaging provides more valuable clues on diagnosis and differentiation of bone metastases,and thus effectively in-creases the diagnostic efficiency in the single and multiple bone metastases,especially in the single bone metastases.%目的：评价CT联合全身骨显像在骨转移瘤中的诊断价值。方法：连续性回顾分析2013年1月至2015年12月期间全身骨显像阳性并同期行同部位CT检查且有原发肿瘤病史的患者资料，根据全身显像核素增浓灶的数目分为单发及多发（具有2个及其以上的病灶），以病理诊断或临床随访诊断为标准，分别对CT、全身骨显像及两者联合这三种不同检查方式在骨转移瘤中的诊断价值进行研究，利用配对χ2（或校正χ2）检验比较CT、全身骨显像与两者联合在单发及多发骨转移瘤诊断中的正确诊断率是否存在统计学差异，利用统计学软件绘制CT、全身骨显像及两者联合在诊断单发及多发骨转移瘤中的ROC曲线。结果：经病理或随访临床证实的212例患者纳入此研究，其中单发核素增浓灶患者91例，多发核素增浓灶患者121例。CT、全身骨显像与两者联合相比在诊断单发及多发骨转移瘤中存在统计学差异（P＜0．05），两者联合诊断单发及多发核素增浓灶的ROC曲线下面积高于单独全身骨显像或CT，并且可以提供更多的诊断及鉴别诊断信息。结论：CT联合全身骨显像可以为骨转移瘤的诊断及鉴别诊断提供更多有价值的信息，能有效提高骨转移瘤、尤其是单发骨转移瘤的诊断准确性。