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目的分析PET/CT技术在非典型脊柱结核影像诊断中的作用。方法收集2010—2016年因脊柱病变在浙江省人民医院行PET/CT检查的60例患者的X光片、CT及PET/CT检查资料,以病理诊断为金标准,采用ROC曲线比较这3种诊断方法的准确性,并描述PET/CT检查的影像学特征。结果 60例患者中,男性52例,女性8例;年龄38~82岁,平均50.2岁。3种影像诊断的统计分析结果显示,PET/CT诊断脊柱结核灵敏度为0.850,特异度为0.950,诊断准确性最高(AUC=0.900,P<0.05);PET/CT融合解剖和功能检查,可发现病灶内存在放射性“冷区”、椎旁“放射性冷脓肿”等特征性表现。PET/CT影像可分为单脊椎型结核、椎间盘型结核和多发性脊柱结核3种类型。结论采用PET/CT技术诊断非典型脊柱结核的准确性高于X线和CT,在难以诊断或怀疑脊柱转移瘤患者中值得推广应用。
Objective To analyze the role of PET / CT in the diagnosis of atypical spinal tuberculosis. Methods The data of X-ray, CT and PET / CT of 60 patients undergoing PET / CT examination in Zhejiang Provincial People’s Hospital from 2010 to 2016 were collected. The pathological diagnosis was taken as the gold standard. The ROC curve was used to compare the three methods Diagnostic methods are accurate and describe the imaging features of PET / CT. Results 60 patients, 52 males and 8 females; aged 38 to 82 years, mean 50.2 years old. The statistical analysis results of three kinds of imaging diagnosis showed that PET / CT had the diagnostic sensitivity of 0.850, the specificity of 0.950 and the highest diagnostic accuracy (AUC = 0.900, P <0.05). PET / CT fusion anatomy and functional examination showed that PET / The presence of radioactive lesions within the “cold zone”, paravertebral “radioactive abscess ” and other characteristic manifestations. PET / CT images can be divided into single spine type tuberculosis, disc type tuberculosis and multiple types of spinal tuberculosis. Conclusion The accuracy of PET / CT in the diagnosis of atypical spinal tuberculosis is higher than that of X-ray and CT, which is worthy of popularization in the diagnosis of patients with spinal metastases.