魏 强 程 洁 田丛娜 边艳珠.河北省人民医：核医学科，河北石家庄05005；.河北省人民医：口腔科，河北石家庄05005

    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

    魏强1程洁2田丛娜1边艳珠1

    1.河北省人民医：核医学科，河北石家庄050051；2.河北省人民医：口腔科，河北石家庄050051

    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：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。

    骨肿瘤曰弥散加权成像曰放射性核素显像曰全身成像

    [Abstract]Objective To exp1ore the va1ues of WB-DWI combined with bone scintigraphy in diagnosing bone metastases.Methods From June 2010 to June 2013,in Hebei Peop1e′s Hospita1,25 patients suspected of bone metastasis were se1ected,they underwent WB-DWI and bone scintigraphy respective1y within a week,a11 images were ana1yzed by doub1e-b1ind method,the existence and 1ocation of foca1 abnorma1 bone imaging were recorded and ana1yzed.The existence and 1ocation of a11 metastases were confirmed by patho1ogy or imaging data or fo11ow-up at 1east 3 months.The sensitivity,specificity,accuracy and Kappa va1ue were ca1cu1ated respective1y for the comparison of diagnostic va1ue of different examinations.Results Sensitivity,specificity,accuracy and Kappa va1ue of diagnosing bone metastases were 83.3%,83.8%,83.5%,0.639 respective1y by WB-DWI,those of bone scintigraphy were 79.5%,32.4%,64.3%,0.127, those of WB-DWI in combination with bone scintigraphy were 93.6%,14.8%,93.0%,0.843.The rate of WB-DWI combined with bone scintigraphy detecting bone metastases was compared with sing1e detecting,the differences were statistica11y significant(P<0.05).Conclusion The sensitivity of diagnosing bone metastases by WB-DWI and bone scintigraphy is simi1ar.WB-DWI combined with bone scintigraphy is a more accurate too1 in detecting bone metastases. ......