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复旦大学附属中山医院核医学科
纸质出版日期:2011-07-01
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[1]张一秋,石洪成,顾宇参,陈曙光,朱玮珉,蔡良,修雁,李蓓蕾.骨SPECT/CT显像对肝细胞癌骨转移诊断的增益价值[J].核技术,2011,34(07):532-536.
ZHANG Yiqiu SHI Hongcheng GU Yushen CHEN Shuguang ZHU Weimin CAI Liang XIU Yan LI Beilei. The added value of SPECT/CT fusion imaging for differential diagnosis of bone metastases in patients with hepatocellular carcinoma[J]. Nuclear techniques, 2011, 34(7): 532-536.
[1]张一秋,石洪成,顾宇参,陈曙光,朱玮珉,蔡良,修雁,李蓓蕾.骨SPECT/CT显像对肝细胞癌骨转移诊断的增益价值[J].核技术,2011,34(07):532-536. DOI:
ZHANG Yiqiu SHI Hongcheng GU Yushen CHEN Shuguang ZHU Weimin CAI Liang XIU Yan LI Beilei. The added value of SPECT/CT fusion imaging for differential diagnosis of bone metastases in patients with hepatocellular carcinoma[J]. Nuclear techniques, 2011, 34(7): 532-536. DOI:
探讨了SPECT/CT骨显像在肝癌骨转移诊断方面较全身骨显像的增益价值。97例病理证实为HCC的患者行全身骨显像和SPECT/CT检查。由2名核医学医师首先对全身骨显像图像进行分析
然后再分析SPECT/CT融合图像
分别给出肿瘤骨转移、非肿瘤骨转移和不能确定的诊断。与临床诊断比较
将全身骨显像和SPECT/CT显像对患者能明确诊断(肿瘤骨转移和非肿瘤骨转移)的归为一组
不能明确诊断(不能确定诊断和诊断错误)的归为另一组
分别计算其百分率及其95%可信区间
并分别计算全身骨显像和SPECT/CT显像对患者肿瘤骨转移与非肿瘤骨转移诊断的符合率及其95%可信区间。与临床诊断相比
97例患者中
全身骨显像能明确诊断的患者共35例
占36.1%(35/97)
其95%可信区间为26.5%-45.6%;不能明确诊断的患者共62例
占63.9%(62/97)
其95%可信区间为54.4%-73.5%;骨转移诊断的符合率为50.0%(24/48)
其95%可信区间为35.9%-64.1%。SPECT/CT融合图像能明确诊断的患者共79例
占81.4%(79/97)
其95%可信区间为73.7%-89.1%;不能明确诊断的患者共18例
占18.6%(18/97)
其95%可信区间为10.9%-26.3%;骨转移诊断的符合率为95.8%(46/48)
其95%可信区间为90.1%-100.0%。SPECT/CT骨显像在肝癌骨转移诊断方面较全身骨显像具有增益价值
提高了诊断的准确性
尤其对于全身骨显像假阴性的病例
具有特殊的意义。
In this paper
the value of differentiating metastases from benign of bone lesions in patients with hepatocellular carcinoma using SPECT/ CT fusion imaging is evaluated.From patients with hepatocellular carcinoma(HCC) confirmed by pathology underwent bone scintigraphy
97 patients were selected to undergo SPECT/CT scanning.The bone scintigraphy and SPECT/CT fusion images were analyzed by two experienced nuclear medicine physicians together.Each patient was rated using a 3-point diagnostic confidence scale:metastasis
benign and uncertainty.The analyzed items were divided into two groups
i.e.certainty to diagnose(metastasis and benign) and uncertainty to diagnose.The percentage and its 95% confidence intervals of each group were calculated.The coincidence rate of bone metastases compared with the final diagnosis and its 95% confidence interval were calculated.The degree of certainty to diagnose on bone scintigraphy was 36.1%(35/97)
its 95% confidence intervals range from 26.5% to 45.6%.The degree of uncertainty to diagnose on bone scintigraphy was 63.9%(62/97)
its 95% confidence intervals range from 54.4% to 73.5%.The coincidence rate of bone metastases was 50.0%(24/48)
its 95% confidence intervals range from 35.9% to 64.1%.The degree of certainty to diagnose on SPECT/CT fusion images was 81.4%(79/97)
its 95% confidence intervals range from 73.7 % to 89.1%.The degree of uncertainty to diagnose on SPECT/CT fusion images was 18.6%(18/97)
its 95% confidence intervals range from 10.9% to 26.3%.The coincidence rate of bone metastases was 95.8%(46/48)
its 95% confidence intervals range from 90.1% to 100%.SPECT/CT fusion images provide more information than bone scintigraphy in differentiating metastases from benign lesions in patients with HCC
increase the degree of certainty to diagnose
especially increase the diagnostic accuracy in some false-negative cases diagnosed by bone scintigraphy.
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