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目的探讨SPECT-CT融合图像评价原发性肝癌骨转移的增益价值。方法回顾性分析临床诊断为原发性肝癌、排除其他恶性肿瘤病史且行全身骨显像及局部SPECT-CT融合图像检查的254例患者的临床资料,根据患者综合表现诊断为肿瘤骨转移和无肿瘤骨转移,以手术病理或随访结果为最终诊断标准。分别计算并比较全身骨显像、SPECT-CT融合图像诊断的灵敏度、特异度、阳性预测值、阴性预测值和正确诊断百分率。结果 254例患者中确诊肿瘤骨转移111例,无肿瘤骨转移143例。SPECT-CT融合图像诊断的灵敏度(93.6%)、特异度(93.7%)、阳性预测值(99%)、阴性预测值(100%)、正确诊断百分率(93.3%)均高于全身骨扫描(42.3%、74.8%、95.7%、92.5%、56.7%)。结论评价肝癌骨转移时,SPECT-CT融合图像较全身骨显像更具有增益价值。
Objective To investigate the value of SPECT-CT fusion in evaluating the bone metastasis of primary liver cancer. Methods The clinical data of 254 patients diagnosed as primary hepatocellular carcinoma, excluding other malignant tumors, and examined by whole body bone imaging and local SPECT-CT fusion were retrospectively analyzed. According to their comprehensive manifestations, they were diagnosed as tumor bone metastases and tumor-free Bone metastasis, with surgical pathology or follow-up results as the final diagnostic criteria. The sensitivity, specificity, positive predictive value, negative predictive value, and correct diagnostic percentage of whole body bone imaging and SPECT-CT fusion imaging were calculated and compared. Results Of the 254 patients, 111 cases were diagnosed as tumor metastasis and 143 cases were without tumor metastasis. The sensitivity (93.6%), specificity (93.7%), positive predictive value (99%), negative predictive value (100%) and correct diagnostic accuracy (93.3%) of SPECT- 42.3%, 74.8%, 95.7%, 92.5%, 56.7%). Conclusions In the evaluation of bone metastasis of liver cancer, SPECT-CT fusion images are more valuable than whole body bone imaging.