目的 探讨99Tcm-亚甲基二磷酸盐(MDP)SPECT/CT骨显像在肿瘤骨转移中的诊断价值.方法 选择126例可疑肿瘤骨转移和不明原因骨痛的患者,行全身骨显像,对发现的阳性病灶(或有不明原因骨疼痛部位)行断层及同机CT扫描,再行图像融合.对患者资料进行回顾性分析,平面显像和SPECT/CT显像结果与病理结果对照10例,与2种以上影像技术(MRI、CT、X线)诊断结果对照58例,与随访1年结果对照58例,计算平面显像和SPECT/CT与这些对照方法的诊断符合率.对平面和SPECT/CT显像的诊断符合率行x2检验.结果 核素影像诊断和对照方法诊断比较,平面显像诊断符合率为43.65%(55/126).SPECT/CT显像诊断符合率为80.16%(101/126).平面显像和SPECT/CT对骨转移的诊断符合率差异有统计学意义(X2=36.60,P<0.01).结论 SPECT/CT显像在全身骨显像的基础上增加了CT诊断信息,可以显示病变部位的细微解剖结构,明显提高了对骨病变诊断的价值.%Objective To evaluate the clinical value of 99Tcm-methylene diphosphonic acid (MDP)SPECT/CT imaging for diagnosis of rnbone metasis. Methods Patients suspected for bone metasis and with bone pain of unknown origin were inineluded in this study (n=126).rnAll cases underwent SPECT and CT imaging at 180 minutes after 99Tcm-MDP ingection .Diagnosis was confirmed by pathology(n=10), more than rntwo kinds of radiological imaging g( MRI, CT, X-ray) (n=58) and clinical of follow up in one years( n=58 ).x2-test was used to compare the rernsuits of planar and SPECT/CT imaging using SPSS 10.0 software. Results In 126 patients,planar imaging of 55 cases matched the final diagrnnosis in which 29 had benign lesions and 26 had bone metastases. The coincidence and definite coincidence rates were 87.30％(55/63), and rn43.65％(55/126).SPECT/CT imaging of 101 cases matched the final diagnosis in which 52 had benign lesions and 49 cases diagnosed as bone rnmetastases. The coincidence and definite coincidence rates were 80.16％ (101/126), and99.02％(101/102). Difference in the definte coincidence rnrates between planar and SPECT/CT imaging was statistically significant( (X2=35.60, P＜0.005 ). Conclusion SPECT/CT imaging is valuable for rnaccurate localization of osseous pathology and for improvement of diagnosing bone metastasis.
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