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[目的]评价SPECT配置2.5mA X射线球管装置系统融合显像对脊柱、肋骨单发浓聚灶良恶性病变的鉴别诊断价值。[方法]选取在全身骨显像中表现为脊柱、肋骨单发浓聚灶的98例恶性肿瘤患者,同时行SPECT配置2.5mA X射线球管装置系统融合显像。并以CT、MRI结果或6~12个月的随访作为最终临床诊断结果,分析全身骨显像和SPECT配置2.5mA X射线球管装置系统融合显像的鉴别诊断效能。[结果]SPECT配置2.5mA X射线球管装置系统融合显像诊断单发浓聚灶骨转移的敏感性84.21%,特异性91.67%,准确性88.78%,阳性预测值86.49%,阴性预测值90.16%。全身骨显像诊断单发浓聚灶骨转移的敏感性60.53%,特异性71.67%,准确性67.35%,阳性预测值57.50%,阴性预测值74.14%。二者敏感性相比差异有统计学意义(P<0.05),特异性和准确性差异均有显著统计学意义(P<0.01)。[结论]SPECT配置2.5mA X射线球管装置系统融合显像可提高对脊柱和肋骨单发浓聚灶良恶性病变的鉴别诊断能力。
[Objective] To evaluate the differential diagnostic value of SPECT with 2.5mA X-ray tube system fusion imaging in benign and malignant lesions of solitary single spine and rib. [Method] A total of 98 patients with malignant tumors, which showed spine and rib solitary focus in whole body bone imaging, were selected and fused with SPECT configuration 2.5mA X-ray tube system simultaneously. The CT and MRI results or the follow-up of 6 to 12 months were used as the final clinical diagnosis results to analyze the differential diagnostic efficacy of whole body bone imaging and SPECT configuration 2.5mA X-ray tube system fusion imaging. [Results] The sensitivity, specificity and accuracy of 84.51%, 91.67%, 88.78%, 86.49% and 90.16, respectively, were significantly higher in SPECT with 2.5mA X-ray tube system fusion imaging. %. The sensitivity and specificity of whole body bone imaging in the diagnosis of single focal thick bone metastasis were 60.53%, 71.67%, 67.35% respectively, the positive predictive value was 57.50% and the negative predictive value was 74.14%. There was significant difference between the two sensitivities (P <0.05). The differences of specificity and accuracy were statistically significant (P <0.01). [Conclusion] SPECT with 2.5mA X-ray tube system fusion imaging can improve the differential diagnosis of benign and malignant lesions of solitary focus in spine and rib.