磁共振全身弥散成像联合核素全身骨显像在骨转移瘤诊断中应用价值.docVIP

磁共振全身弥散成像联合核素全身骨显像在骨转移瘤诊断中应用价值 　　[摘要] 目的 探讨磁共振全身弥散成像（WB-DWI）联合核素全身骨显像在诊断恶性肿瘤骨转移的临床应用价值。 方法 选取2010年6月～2013年6月在河北省人民医院就诊的25例疑似恶性肿瘤骨转移患者，于1周内分别行WB-DWI显像和核素全身骨显像，对两种检查图像行双盲法判读，记录两种检查图像中的骨异常显像灶的数量及位置并逐一对比分析。以活检病理、综合多种影像学检查或随访至少3个月结果确定骨转移灶的存在及位置。统计单独及联合应用两种影像方法诊断骨转移病灶的敏感度、特异性、准确度和Kappa值，比较两种影像学检查方法分别及联合应用在骨转移瘤诊断中的价值是否存在统计学差异。 结果 单独WB-DWI显像对25例可疑骨转移瘤患者115处可疑骨转移灶诊断的敏感度、特异性、准确率、Kappa值分别为83.3%、83.8%、83.5%、0.639。单独核素全身骨显像诊断骨转移瘤的敏感度、特异性、准确率、Kappa值分别为79.5%、32.4%、64.3%、0.127。而两者联合诊断骨转移瘤的敏感度、特异性、准确率、Kappa值分别为93.6%、14.8%、93.0%、0.843。两者联合应用对骨转移瘤的检出率与单独采用任一检查方法差异有统计学意义（P 0.05）。 结论 WB-DWI与核素全身骨显像对骨转移瘤的诊断敏感度相当，两者联合应用能明显提高骨转移瘤诊断的准确度。 　　[关键词] 骨肿瘤；弥散加权成像；放射性核素显像；全身成像 　　[中图分类号] R738.1；R730.44 [文献标识码] A [文章编号] 1673-7210（2016）04（a）-0019-04 　　Application value of WB-DWI combined with bone scintigraphy in diagnosing bone metastases 　　WEI Qiang1 CHENG Jie2 TIAN Congna1 BIAN Yanzhu1 　　1.Department of Nuclear Medicine， Hebei Peoples Hospital， Hebei Province， Shijiazhuang 050051， China； 2.Department of of Orthodontic， Hebei Peoples Hospital， Hebei Province， Shijiazhuang 050051， China 　　[Abstract] Objective To explore the values of WB-DWI combined with bone scintigraphy in diagnosing bone metastases. Methods From June 2010 to June 2013， in Hebei Peoples Hospital， 25 patients suspected of bone metastasis were selected， they underwent WB-DWI and bone scintigraphy respectively within a week， all images were analyzed by double-blind method， the existence and location of focal abnormal bone imaging were recorded and analyzed. The existence and location of all metastases were confirmed by pathology or imaging data or follow-up at least 3 months. The sensitivity， specificity， accuracy and Kappa value were calculated respectively for the comparison of diagnostic value of different examinations. Results Sensitivity， specificity， accuracy and Kappa value of diagnosing bone metastases were 83.3%， 83.8%， 83.5%， 0.639 respectively by WB-DWI， those of bone scintigraphy were 79.5%， 32.4%， 64.3%， 0.127