摘要目的 探讨SPECT/CT显像诊断异位胃黏膜的临床价值.方法 对临床怀疑Meckel憩室的31例患者(男21例,女10例,年龄8个月～ 14岁)行腹盆部99Tcm0-4动态平面显像,并于20 min平面显像结束后立即行腹盆部SPECT/CT显像.通过x2检验比较动态平面显像、融合显像及两者联合应用的诊断效能,以术后病理、胃肠镜检查及临床随访结果作为最终诊断.结果 术后病理结果示18例为异位胃黏膜患者.平面显像提示阳性25例,阴性6例;SPECT/CT融合显像提示阳性18例,阴性13例.两者对异位胃黏膜诊断的特异性(5/13与12/13)与准确性[70.97％(22/31)与93.55％(29/31)]差异有统计学意义(x2=6.118、5.415,均P＜0.05).两者联合应用的灵敏度、特异性、阳性预测值、阴性预测值及准确性分别为17/18、13/13、17/17、13/14和96.77％(30/31).结论 与平面显像相比,SPECT/CT显像可提高异位胃黏膜检查的特异性,两者联合应用诊断价值更高.

abstractsObjective To evaluate the diagnostic efficacy of 99TcmO-4 planar imaging combined SPECT/CT fusion imaging in patients with ectopic gastric mucosa (EGM).Methods Thirty-one patients (21 males,10 females,age range:8 months to 14 years) suspected of Meckel diverticulum were enrolled in this study.99TcmO7-4 SPECT planar imaging was performed normally,followed by SPECT/CT fusion imaging at 20 min after 99TcmO-4 injection.Pathological results,gastrointestinal endoscopy results and clinical follow-up were taken as the gold standard.The diagnostic efficacy of planar imaging,fusion imaging and the combined method of the two were compared by x2 test.Results There were 18 EGM patients according to the pathological results.Planar imaging suggested 25 positive and 6 negative cases,while fusion imaging found positive results in 18 patients and negative results in 13 patients.The specificity (5/13 vs 12/13) and accuracy (70.97％ (22/31) vs 93.55％ (29/31)) of the two methods were significantly different (x2=6.118,5.415,both P＜0.05).When the fusion imaging was combined with the planar imaging,the diagnostic sensitivity,specificity,positive predictive value,negative predictive value and accuracy were 17/18,13/13,17/17,13/14,96.77％(30/31),respectively.Conclusions Compared with the planar imaging,SPECT/CT imaging can improve the diagnostic specificity for Meckel diverticulum,and the combination of fusion imaging and planar imaging may be more valuable.