| 祝安惠,王荣福.99mTc-MDP全身骨显像联合MR成像对骨转移瘤诊断的临床应用[J].肿瘤学杂志,2014,20(11):881-888. |
| 99mTc-MDP全身骨显像联合MR成像对骨转移瘤诊断的临床应用 |
| Application of 99mTc-MDP Whole Body Bone Scan Combined with MR on the Diagnostic Value of Bone Metastasis |
| 投稿时间：2014-08-21 |
| DOI：10.11735/j.issn.1671-170X.2014.11.B003 |
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| 中文关键词: 骨转移瘤 骨显像 单光子计算机断层显像 磁共振成像 |
| 英文关键词:bone metastatic tumor bone scintigraphy single emission computed tomography(SPECT) magnetic resonance imaging |
| 基金项目:国家自然科学基金(81071183） |
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| 中文摘要: |
| 摘 要：［目的］ 探讨99mTc-MDP 全身骨显像联合MR成像对骨转移瘤的诊断价值。［方法］ 回顾性研究经临床证实的50例骨转移瘤患者的99mTc-MDP 全身骨显像与MR成像结果。对比分析全身骨显像、MR成像、全身骨显像联合MR成像对骨转移瘤病变诊断的灵敏度、特异性、准确率、阳性预测值和阴性预测值；采用McNemar检验分析全身骨显像与全身骨显像联合MR成像对骨转移瘤的诊断效能。［结果］ 50例患者中，MR检查阳性50例，诊断灵敏度为100%（50/50）；全身骨显像检查阳性48例，诊断灵敏度为96%（48/50），全身骨显像联合MR成像检查阳性50例，诊断灵敏度为100%（50/50）。MR、全身骨显像对相同的受检部位共检出病变194处，其中经临床确诊的转移灶共182 处，良性病灶12处。MR共检出转移性病变182处；全身骨显像共检出转移性病变122处，假阴性病变60处，假阳性病变12处。MR诊断骨转移瘤的灵敏度、准确率、阳性预测值分别为100%（182/182）、100%(194/194)、93.81%（182/194）；全身骨显像诊断转移瘤的灵敏度、准确率、阳性预测值分别为67.03%(122/182)、62.89%(122/194)、91.04%(122/134)；MR联合全身骨显像诊断转移瘤的灵敏度、准确率、阳性预测值与MR检查结果相同。全身骨显像联合MR成像与全身骨显像相比，两者的诊断效能统计学差异具有显著意义（P<0.05）。［结论］ MR对各型骨转移瘤均有异常表现，且对早期骨髓浸润转移具有明显优势，而全身骨显像联合MR成像对骨转移瘤的诊断效能明显优于全身骨显像。 |
| 英文摘要: |
| Abstract：［Purpose］ To evaluate diagnostic value of 99mTc-MDP whole body bone scan combined with MRI on the bone metastasis in patients with malignancies．［Methods］ A total of 50 patients with bone metastasis enrolled in this study． All patients underwent MRI and BS with 99mTc-MDP in two weeks． Based on the diagnostic results of patients，sensitivity，specificity，accuracy，positive predictive value（PPV） and negative predictive value（NPV）of MRI，BS and MRI combined with BS method to detect bone metastasis were calculated． Moreover，we compared diagnostic value between BS and MRI combined with BS methods by McNemar test. ［Results］For MRI，BS and MRI combined with BS，the sensitivity of detecting bone metastasis was 100%（50/50），96%（48/50）and 100%（50/50），respectively. A total of 194 lesions detected by MRI and BS. Of them，clinical diagnosis of metastases in 182 and benign in 12. 182 lesions were detected by MRI and 122 by BS. Of these lesions，60 were false negative and 12 false positive． For MRI，BS and MRI combined with BS，the sensitivity，accuracy and PPV of detecting bone metastasis were 100%（182/182），100%(194/194)，93.81%（182/194）；67.03%(122/182)，62.89%(122/194)，91.04%(122/134) and 100%（182/182），100%(194/194)，93.81%（182/194）respectively. The diagnostic value of MRI combined with BS was obviously higher than that of BS(P<0．05)． ［Conclusion］ All types of bone metastasis can be detected by MRI. The diagnostic value of MRI combined with BS for bone marrow metastasis is obviously better than that of BS only. |
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