SPECT对恶性肿瘤骨转移的诊断价值及临床应用.docVIP

精品论文 参考文献 SPECT对恶性肿瘤骨转移的诊断价值及临床应用 张慧娟 平煤神马医疗集团总医院核医学科（467000） 摘要 目的:探讨SPECT(单光子发射计算机体层摄影，single photon emission computed tomography，SPECT)诊断恶性肿瘤骨转移的临床价值。方法:经影像学检查、手术治疗及穿刺活检最后病理证实的2000 例恶性肿瘤患者,对其SPECT 影像资料进行回顾性分析,总结归纳其影像特点。结果: 2000 例恶性肿瘤患者中经SPECT 检查及病理证实有1125 例发生骨转移。①恶性肿瘤发生骨转移的阳性率:前列腺癌发生骨转移的阳性率为74.1%,乳腺癌阳性率69.1%，肺癌阳性率54.7%,鼻咽癌阳性率45.3% ,消化道恶性肿瘤阳性率29.1%,其他肿瘤阳性率22.5%。②肿瘤转移部位依次以脊柱、肋骨、骨盆、颅骨、胸骨较为多见。③恶性肿瘤骨转移灶SPECT 显像主要表现为放射性浓聚、缺损以及浓聚与缺损混合存在三种影像特点。④SPECT 显示骨转移癌的阳性率为100%，诊断准确率为96.9%（多发病灶）和70.1％（单发病灶）。⑤恶性肿瘤骨转移率与病程有关。结论:SPECT 对恶性肿瘤骨转移患者的早期诊断、疾病分期、治疗方案的选择、预后评估有重要的临床价值。 关键词单光子发射计算机体层摄影恶性肿瘤骨转移瘤诊断价值临床应用 [中图分类号] R817.4 [文献标识码]A [文章编号] Diagnostic value and Clinical Application of SPECT in diagnosis of bone metastases in Patients with malignant tumorZHANG Hui-juan(Department of Nuclear Medicine, The General Hospital of Pingmei shenma Medical Group, Hersquo;nan 467000, China)Abstract Objective:To investigate the diagnostic value and clinical application of SPECT in diagnosis of bone metastases in Patients with malignant tumor.Methods:SPECT findings in 2000 cases with malignant tumor proved by pathology were respectively analyzed and summarized. Results:Among 2000cases,1125 patients were diagnosed bone metastases proved by pathology.①The positive rate of bone metastases in patients with prostate cancer, breast cancer,lung cancer, nasopharyngeal carcinoma, gastrointestinal carcinoma and others were 74.1%,69.1%,54.7%,45.3%,29.1%and22.5% respectively.②Frequent sites of bone metastases were the spine,ribs,pelvic bone,skull and sternum.③Most of bone metastases showed “hot”,“cold”and“hot”with“cold”spots. ④The diagnostic sensitivity of SPECT is 100%, The diagnostic accuracy are 96.9%( multiple bone metastases) and 70.1%(single bone metastasis) respectively. ⑤The rate of metastases was related with course of malignant tumor. Conclusion:SPECT has important clinic values for patients with malignant tumor in earlydiagnosis of bone metastases,treatment,staging and prognosis. Key words single photo