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1、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（单光了发射计算机体层摄影，singlephotonemissioncomputedtomography,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例发牛骨转移。①恶性肿瘤发牛骨转移的阳性率:前列腺癌发牛骨转移的阳性率为74.1%,乳腺癌阳性率69.1%,肺癌阳性率54.
2、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%o②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］Di
3、agnoSticvalueandClinicalApplicationofSPECTindiagnosisofbonemetastasesinPatientswithmalignanttumorZHANGHui-juan（DepartmentofNuclearMedicine,TheGeneralHospitalofPingmeishenmaMedicalGroup,He’nan467000,China）AbstractObjective:ToinvestigatethediagnosticvalueandclinicalapplicationofSPECTindiagnos
4、isofbonemetastasesinPatientswithmalignanttumor.Methods:SPECTfindingsin2000caseswithmalignanttumorprovedbypathologywererespectivelyanalyzedandsummarized.Results:Among2000cases,1125patientswerediagnosedbonemetastasesprovedbypathology.®Thepositiverateofbonemetastasesinpatientswithprostatecancer,brea
5、stcancer,lungcancer,nasopharyngealcarcinoma,gastrointestinalcarcinomaandotherswere74.1%/69.1%/54.7%,45.3%,29.1%and22.5%respectively.②Frequentsitesofbonemetastaseswerethespinejibs’pelvicbone,skullandsternum•③Mostofbonemetastasesshowed"hot；〃cold〃and"hot〃with〃cold〃spots.@ThediagnosticsensitivityofSP
6、ECTis100%,Thediagnosticaccuracyare96.9%(multiplebonemetastases)and70.1%(singlebonemetastasis)respective!y.⑤Therateofmetastaseswasrelatedwithcourseofmalignanttumor.Conclusion:SPECThasimportantclinicvaluesforpatientswithmalignanttumorinearlydiagnosisofbonemetastases,treatment,stagingandprognosis.Ke
7、ywordssinglephotonemissioncomputedtomography;malignanttumor;bonemetastases;diagnoSticvalue;clinicalapplication恶性肿瘤常发牛骨转移,肺癌、乳腺癌和前列腺癌的患者约有70%-85%发牛骨转移，肿瘤患者尸检显示50%存在骨转移，70%以上患者有骨痛症状［1］。早期发现肿瘤骨转移对于疾病的诊断、分期、治疗方案的选择、患者生命的延长
