18F-FDG hPET-CT显像探测恶性肿瘤骨病灶的临床价值.DOCVIP

临床医学论文-18F-FDG hPET/CT显像探测恶性肿瘤骨病灶的临床价值 ?????????????????????????????? 作者：赵晋华? 车文军? 张闻瑞? 陆荣华 ?【关键词】? 99Tcm-亚甲基膦酸盐 【摘要】 目的 比较 18F-脱氧葡萄糖（FDG）hPET/CT显像与99Tcm-亚甲基膦酸盐（MDP）全身骨显像检测恶性肿瘤骨骼病灶的异同点，探讨18F-FDG hPET/CT显像诊断恶性肿瘤骨病灶的临床价值。方法 43例在1个月内行18F-FDG hPET/CT显像与99Tcm-MDP全身骨显像的恶性肿瘤患者。22例经病理、影像学检查诊断为肿瘤骨转移，21例除外了骨转移诊断。结果18F-FDG hPET/CT显像诊断恶性肿瘤骨转移的灵敏度、特异性、准确性为90.9%，81.0%和81.4%，99Tcm-MDP全身骨显像为81.8%，71.4%和76.7%，差异无显著性（P均0.05）。18F-FDG hPET/CT显像共发现骨病灶132处，99Tcm-MDP全身骨显像发现89处。结论18F-FDG hPET/CT显像对探测恶性肿瘤骨病灶、临床分期、评价疗效具有独特价值。 关键词 骨肿瘤 肿瘤转移 体层摄影术 发射型计算机 脱氧葡萄糖 99Tcm-亚甲基膦酸盐? 【Abstract】 Objective To investigate the clinical value of hPET/CT with 18F-2-fluorodeoxyglucose（FDG）in detection of bone metastases，and to compare the results of FDG hPET/CT with that of 99Tcm-methylene diphosphonic acid（MDP）whole-body bone scan.Methods Forty-three patients with malignancy tumor underwent 18F -FDG hPET/CT imaging and? 99Tcm-MDP bone scan within one month apart.Twenty-two of them were confirmed of bone metastases and the remaining twenty-one patients were excluded of bone metastases.Results The sensitivity，specificity and accuracy of 18F-FDG hPET/CT imaging and? 99Tcm-MDP bone scan for diagnosing of bone metastases were90.9%，81.0%，81.4%and81.8%，71.4%，76.7%，respectively（P0.05）.There is no significant difference between these two methods.Conclusion 18F-FDG hPET/CT imaging has special values in detecting bone metastases，staging，therapy evaluating. Key words bone neoplasms neoplasm metastasis tomography emission-computed deoxyglucose MDP? 99Tcm-亚甲基膦酸盐（MDP）全身骨显像是检测恶性肿瘤骨转移的常规方法，而18F-脱氧葡萄糖（FDG）PET显像可显示具有葡萄糖高代谢水平的骨骼转移病灶。本研究目的是比较18F-FDG hPET/CT显像与99Tcm-MDP全身骨显像检测恶性肿瘤骨骼病灶的异同点，探讨18F-FDG hPET/CT显像诊断恶性肿瘤骨转移病灶的临床价值。 1 资料与方法 1.1 一般资料 43例恶性肿瘤患者，男28例，女15例，年龄32～82岁。经手术或病理证实原发灶明确者35例，包括肺癌12例，乳腺癌5例，胃肠道肿瘤5例，恶性淋巴瘤4例，前列腺癌2例，肝癌2例，双癌2例（分别为肺癌+膀胱癌、直肠癌+肾癌），宫颈癌1例，恶性黑色素瘤1例，肾上腺肿瘤1例;其余8例为原发灶不明但出现明显骨转移灶者。均在1个月内分别行18F-FDG hPET/CT显像与99Tcm-MDP全身骨显像。 1.2 显像仪器及显像剂 显像仪器为GE Discovery VH+Hawkeye双探头hPET/CT仪。18F-FDG由华山医院PET中心提供，放化纯度95%。99Tcm-MDP由中国原子