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目的 探讨99Tcm-MDP SPECT/CT骨显像对腰椎峡部裂的诊断价值.方法 回顾性分析2012年1月至2014年5月间58例下腰背部疼痛患者(男28例,女30例;平均年龄61.3岁)SPECT骨扫描平面采集及腰椎SPECT/CT融合显像资料,综合SPECT/CT和随访CT结果作为诊断标准,分别计算SPECT显像、CT和SPECT/CT融合显像诊断腰椎峡部裂的灵敏度和准确性,不同方法的诊断结果比较采用x2检验.结果 58例患者中,28例患者诊断为腰椎峡部裂.SPECT显像、CT及SPECT/CT融合显像对腰椎峡部裂的诊断灵敏度分别为53.6％(15/28)、78.6％(22/28)和100％ (28/28),诊断准确性分别为48.3％(28/58)、89.7％(52/58)和93.1％(54/58);SPECT/CT融合显像的诊断准确性高于SPECT显像(x2=28.13,P＜0.05).结论 SPECT/CT骨显像对腰椎峡部裂早期诊断有良好的应用价值.

Objective To evaluate the diagnostic value of 99Tcm-MDP SPECT/CT in the diagnosis of lumbar spondylolysis.Methods A total of 58 patients (28 males,30 females,average age 61.3 years) who underwent bone scan and SPECT/CT because of low back pain from January 2012 to May 2014 were retrospectively evaluated.The final diagnosis was based on comprehensive results of SPECT/CT and followup.The diagnostic sensitivity and accuracy of SPECT,CT and SPECT/CT images were calculated and x2 test was performed to analyze the data.Results Twenty-eight patients were diagnosed as lumbar spondylolysis.The diagnostic sensitivities of SPECT,CT and SPECT/CT were 53.6％ (15/28),78.6％ (22/28) and 100％(28/28).The diagnostic accuracies of SPECT,CT and SPECT/CT were 48.3％ (28/58),89.7％ (52/58) and 93.1％(54/58).SPECT/CT was proved to be more accurate than SPECT(x2=28.13,P＜ 0.05).Conclusion SPECT/CT bone scan may detect lumbar spondylolysis in early stage.