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目的介绍骨转移瘤的Na18F PET/CT显像,并比较其与Na18F PET和99Tcm-亚甲基二膦酸盐(MDP)ECT显像对骨转移病灶的诊断效能。方法对临床15例多发性骨转移瘤患者,分别行Na18F PET/CT、Na18F PET和99Tcm-MDP ECT显像,将肉眼可见的骨骼热区记为转移、无法定性和非转移病灶,通过临床随访最终定性诊断为转移病灶、非转移病灶,比较3种检查方法探测骨转移灶的灵敏度、特异度和准确率。结果 Na18F PET/CT和Na18F PET均检出全部168处病灶,99Tcm-MDP ECT探测到全部病灶的64.88%(109/168)。当无法定性的病灶被计入转移病灶时,Na18F PET/CT、Na18F PET和99Tcm-MDP ECT的灵敏度、特异度分别为100%、100%;99.17%、72.92%;66.67%、39.58%。前两者与后者之间差异均有统计学意义(χ2=17.8、χ2=8.2、χ2=18.0、χ2=25.4,P均<0.05)。当无法定性的病灶被计入非转移病灶时,Na18F PET/CT、Na18F PET和99Tcm-MDP ECT的灵敏度、特异度分别为100%、93.75%;93.33%、79.17%;57.50%、81.25%。PET/CT、PET较ECT灵敏度差异均有统计学意义(χ2=26.1、χ2=22.5,P均<0.05),而特异度差异均无统计学意义(χ2=4.8、χ2=0.44,P均>0.05)。结论 Na18F PET/CT用于骨转移瘤显像具有高灵敏度、高特异度兼备的优势。
Objective To introduce Na18F PET / CT imaging of bone metastases and to compare the diagnostic efficacy of Na18F PET and 99Tcm-methylene diphosphonate (MDP) ECT imaging on bone metastases. Methods Fifteen patients with multiple bone metastases in our hospital were treated with Na18F PET / CT, Na18F PET and 99Tcm-MDP ECT respectively. The visible bones were classified as metastatic, non-qualitative and non-metastatic lesions. The clinical follow-up The final qualitative diagnosis of metastatic lesions, non-metastatic lesions, compared with three detection methods to detect bone metastases sensitivity, specificity and accuracy. Results All 168 lesions were detected in Na18F PET / CT and Na18F PET, and 64.88% (109/168) of all lesions were detected by 99Tcm-MDP ECT. The sensitivity and specificity of Na18F PET / CT, Na18F PET and 99Tcm-MDP ECT were 100%, 100%, 99.17%, 72.92%, 66.67% and 39.58%, respectively, when the undeniable lesions were counted as metastatic lesions. The difference between the former two and the latter was statistically significant (χ2 = 17.8, χ2 = 8.2, χ2 = 18.0, χ2 = 25.4, P <0.05). The sensitivity and specificity of Na18F PET / CT, Na18F PET and 99Tcm-MDP ECT were 100%, 93.75%, 93.33%, 79.17%, 57.50% and 81.25%, respectively, when undeniable lesions were included in non-metastatic lesions. There was significant difference in the sensitivity of PET / CT and PET between ECT and ECT (χ2 = 26.1, χ2 = 22.5, P <0.05), but there was no significant difference in specificity between two groups (χ2 = 4.8, 0.05). Conclusion Na18F PET / CT has the advantages of high sensitivity and high specificity in the imaging of bone metastases.