山东大学学报 (医学版) ›› 2018, Vol. 56 ›› Issue (2): 41-46.doi: 10.6040/j.issn.1671-7554.0.2017.827
• • 上一篇
王善容,丁月云,朱宗平,石德道,刘晚霞,郑飞波
WANG Shanrong, DING Yueyun, ZHU Zongping, SHI Dedao, LIU Wanxia, ZHENG Feibo
摘要： 目的 探讨单光子发射计算机断层成像技术/电子计算机X射线断层扫描技术(SPECT/CT)融合骨显像在诊断肺癌单发骨转移中的价值。 方法 回顾性分析2014年6月至2015年6月行全身骨显像并对单发可疑病灶行SPECT/CT断层融合显像进一步检查的肺癌患者80例,分别统计两种方法的诊断结果,并与最终结果对照。病理确定3例,由2种以上影像技术结果确定45例,随访结果确定32例。计算两者灵敏度、特异性、准确性、阳性预测值、阴性预测值。采用SPSS 17.0统计学软件, χ2检验比较全身骨显像与SPECT/CT融合骨显像的诊断结果。 结果 全身骨显像和SPECT/CT断层融合显像对肺癌骨转移的诊断效能分别是:特异性58.3% vs 91.7%(χ2=10.67,P<0.05),准确性71.3% vs 90.0%(χ2=9.002,P<0.05),阳性预测值70.6% vs 92.9%(χ2=7.318,P<0.05),灵敏度81.8% vs 88.6%(χ2=0.81,P>0.05),阴性预测值72.4% vs 86.8%(χ2=0.81,P>0.05)。 结论 SPECT/CT断层融合显像诊断肺癌单发骨转移的特异性、准确性、阳性预测值优于全身骨显像。SPECT/CT融合骨显像诊断肺癌单发骨转移具有重要价值。
中图分类号:
| [1] Horger M, Bares R. The role of single-photon emission computed tomography/computed tomography in benign and malignant bone disease[J]. Semin Nucl Med, 2006, 36(4): 286. [2] Utsunomiya D, Shiraishi S, Imuta M, et al. Added value of SPECT/CT fusion in assessing suspected bone metastasis: comparison with scintigraphy alone and nonfused scintigraphy and CT[J]. Radiology, 2006, 238(238): 264-271. [3] Israel O, Keidar Z, Iosilevsky G, et al. The fusion of anatomic and physiologic imaging in the management of patients with cancer[J]. Semin Nucl Med, 2001, 31(3): 191. [4] 张一秋, 石洪成, 顾宇参, 等. SPECT/CT骨显像对肺癌骨转移诊断的增益价值[J]. 中华核医学与分子影像杂志, 2011, 31(4): 219-222. ZHANG Yiqiu, SHI Hongcheng, GU Yushen, et al. The added diagnostic value of SPECT/CT imaging for bone metastases from lung cancer[J]. Chinese journal of Nuclear Medicine, 2011, 31(4): 219-222. [5] 王新华, 赵艳萍, 陆海健,等. SPECT/CT显像诊断转移性骨肿瘤的临床意义[J]. 中华核医学与分子影像杂志, 2010, 30(2): 106-109. WANG Xinhua, ZHAO Yanping, LU Haijian, et al. Clinical value of SPECT/CT imaging in the diagnosis of bone metastasis[J]. Chinese Journal of Nuclear Medicine and Molecular Imaging, 2010, 30(2): 106-109. [6] Sharma P, Kumar R, Singh H, et al. Indeterminate lesions on planar bone scintigraphy in lung cancer patients: SPECT, CT or SPECT-CT?[J]. Skeletal Radiol, 2012, 41(7): 843. [7] Utsunomiya D, Shiraishi S, Imuta M, et al. Added value of SPECT/CT fusion in assessing suspected bone metastasis: comparison with scintigraphy alone and nonfused scintigraphy and CT[J]. Radiology, 2006, 238(1): 264-271. [8] 肖壮伟, 李俊雄. 核素骨显像对骶髂关节、髋关节及脊柱关节病的诊断[J]. 中华核医学与分子影像杂志, 2000, 20(5): 211-212. XIAO Zhuangwei, LI Junxiong. Bone scintigraphic imaging of sacroiliac joint, hip joint and spondyloarthritis[J]. Chinese Journal of Nuclear Medicine and Molecular Imaging, 2000, 20(5): 211-212. [9] 陈刚, 王铁, 杨燕芬,等. 全身骨显像在肺癌骨转移诊断中的应用及其影像特点[J]. 中国医学影像技术, 2009, 25(6): 1093-1095. CHEN Gang, WANG Tie, YANG Yanfen, et al. Application and characteristics of whole-body bone scanning in detecting bone metastases in lung cancer[J]. Chinese Journal of Medical Imaging Technology, 2009, 25(6): 1093-1095. [10] Oliveira MB, Mello FC, Paschoal ME. The relationship between lung cancer histology and the clinicopathological characteristics of bone metastases[J]. Lung Cancer, 2016, 96(1): 19-24. [11] 刘海荣, 于金明, 李岩, 等. ER、PR、C-erB-2与肺腺癌骨转移的相关性研究[J]. 山东大学学报(医学版), 2012, 50(4): 91-95. LIU Hairong, YU Jinming, LI Yan, et al. Study of the relationship between ER,PR,C-erB-2 and bone metastasis of lung adenocacinoma[J]. Journal of Shandong University(Health Sciences), 2012, 50(4): 91-95. [12] 邢岩, 赵晋华, 汪太松, 等. 18F-FDG SPECT/CT诊断肺癌骨转移的价值: 与全身骨显像比较[J]. 中国医学计算机成像杂志, 2007, 13(3): 213-216. XING Yan, ZHAO Jinhua, WANG Taisong, et al. 18F-FDG SPECT/CT detection of bone metastases from lung cancer: comparison of 99Tcm-MDP whole- body bone scan[J].Chinese Computed Medical Imaging, 2007, 13(3): 213-216. [13] 董科, 石洪成, 刘江, 等. SPECT/CT显像在肿瘤骨转移同一病灶动态随访中的价值[J]. 中华核医学与分子影像杂志, 2013, 33(3): 199-202. DONG Ke, SHI Hongcheng, LIU Jiang, et al. Value of SPECT/CT imaging for follow-up of bone metastases[J]. Chinese Journal of Nuclear Medicine and Molecular Imaging, 2013, 33(3): 199-202. [14] Chen XL, Li Q, Cao L, et al. Diagnostic role of(99)Tc(m)-MDP SPECT/CT combined SPECT/MRI multi modality imaging for early and atypical bone metastases[J]. Int J Clin Exp Med, 2014, 7(12): 5336-5341. [15] 常城, 谢文晖, 雷贝, 等. SPECT/CT融合显像对肺癌单发骨转移瘤的诊断价值[J]. 核技术, 2013, 36(9): 50-55. CHANG Cheng, XIE Wenhui, LEI Bei, et al. SPECT/CT fusion imaging for differential diagnosis of bone solitary metastases in patients with lung cancer[J]. Nuclear Techniques, 2013, 36(9): 50-55. [16] 孟德刚, 孙晓光, 黄钢, 等. SPECT/CT骨显像在骨扫描诊断中的诊断价值[J]. 医学影像学杂志, 2011, 21(2): 274-279. MENG Degang, SUN Xiaoguang, HUANG Gang, et al. The diagnostic value of SPECT/CT in the bone scanning[J]. Journal of Medical Imaging, 2011, 21(2): 274-279. [17] Zhao QT, Yang ZX, Yang L, et al. Diagnostic value of bone-specific alkaline phosphatase in lung carcinoma patients with bone metastases: a meta-analysis[J]. Int J Clin Exp Med, 2015, 8(10): 17271. [18] Costelloe CM, Rohren EM, Madewell JE, et al. Imaging bone metastases in breast cancer: techniques and recommendations for diagnosis[J]. Lancet Oncol, 2009, 10(6): 606. [19] Abikhzer G, Gourevich K, Kagna O, et al. Whole-body bone SPECT in breast cancer patients: the future bone scan protocol?[J]. Nucl Med Commun, 2016, 37(3): 247. [20] Gnanasegaran G, Barwick T, Adamson K, et al. Multislice SPECT/CT in benign and malignant bone disease: when the ordinary turns into the extraordinary[J]. Semin Nucl Med, 2009, 39(6): 431-442. [21] Sodee DB, Sodee AE, Bakale G. Synergistic value of single-photon emission computed tomography/computed tomography fusion to radioimmunoscintigraphic imaging of prostate cancer[J]. Semin Nucl Med, 2007, 37(1): 17-28. [22] Peterson JJ, Kransdorf MJO, Connor MI. Diagnosis of occult bone metastases: positron emission tomography[J]. Clin Orthop Relat Res, 2003, 415(415 Suppl): 120. [23] Eiber M, Takei T, Souvatzoglou M, et al. Performance of whole-body integrated 18F-FDG PET/MR in comparison to PET/CT for evaluation of malignant bone lesions[J]. J Nucl Med, 2014, 55(2): 191-197. [24] Kwee TC, Takahara T, Ochiai R, et al. Diffusion-weighted whole-body imaging with background body signal suppression(DWIBS): features and potential applications in oncology[J]. Eur Radiol, 2008, 18(9): 1937. [25] Layer G, Steudel A, Schüller H, et al. Magnetic resonance imaging to detect bone marrow metastases in the initial staging of small cell lung carcinoma and breast carcinoma[J]. Cancer, 1999, 85(4): 1004-1009. [26] Yilmaz MH, Ozguroglu M, Mert D, et al. Diagnostic value of magnetic resonance imaging and scintigraphy in patients with metastatic breast cancer of the axial skeleton: a comparative study[J]. Med Oncol, 2008, 25(3): 257-263. |
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