Value of quantitative 99mTc-MDP SPECT/CT in elderly osteoporotic spinal compression fractures
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摘要:
目的 探讨定量单光子发射计算机断层扫描（SPECT）/CT获得的标准摄取值在老年骨质疏松性椎体压缩骨折的临床价值。 方法 回顾性分析2019年8月~2021年6月于我院就诊的65例骨质疏松性压缩骨折患者的临床资料。患者分别接受 99mTc-MDP 全身骨显像、局部SPECT/CT断层显像及磁共振成像。根据临床病史，将107个骨折椎体分为新鲜组（n=60）及陈旧组（n= 47），通过图像处理分析，分别计算两组椎体最大标准摄取值（SUVmax）以及平面图像和断层图像的靶区/非靶区比值（T/NT）并比较差异；绘制ROC曲线来获得SUVmax及T/NT的最佳临界值，并比较其诊断效能。 结果 新鲜组、陈旧组及正常组椎体SUVmax分别为43.20±17.17、10.71±3.17及9.78±2.95，新鲜组与陈旧组的差异有统计学意义（P < 0.01），而陈旧组与正常组的差异无统计学意义（P > 0.05）；平面显像T/NT分别为2.22±0.70及1.41±0.45，差异有统计学意义（P < 0.01）；断层显像T/NT分别为5.06±3.52及2.08±0.73，差异有统计学意义（P < 0.01）。通过绘制ROC曲线获得SUVmax、平面显像T/NT及断层显像T/NT的最佳临界值进行鉴别诊断，SUVmax的诊断敏感度、特异性、诊断一致性均高于平面显像T/NT及断层显像T/NT。 结论 定量SPECT/CT标准摄取值在老年骨质疏松性压缩骨折的诊断中具有重要的参考价值，为临床治疗提供客观依据。 -
关键词:
- 压缩骨折 /
- 单光子发射计算机断层摄影术 /
- SPECT/CT定量分析 /
- 骨质疏松 /
- 标准摄取值
Abstract:Objective To investigate the clinical value of standard uptake value obtained by quantitative single-photon-emission computed tomography (SPECT)/CT in elderly osteoporotic spinal compression fractures. Methods Sixty-five patients with osteoporotic compression fractures who underwent 99mTc-MDP whole body bone scan, SPECT/CT scan and magnetic resonance imaging(MRI) from August 2019 to June 2021 were enrolled. Based on the clinical history, 107 fractured vertebrae were divided into fresh group (n=60) and old group (n=47), the maximum standard uptake value (SUVmax) and the target/non-target ratio (T/NT) between the two groups was compared. Analyze the correlation between the SUVmax of the fractures and the injury time. ROC curves were plotted to obtain the cut-off values of SUVmax and T/NT and to compare their diagnostic value. Results The vertebral SUVmax was 43.20 ± 17.17, 10.71 ± 3.17 and 9.78 ± 2.95 in the fresh, old and normal groups, respectively, with significant differences between the fresh and old groups (P < 0.01) and no significant differences between the old and normal groups (P > 0.05). The planar T/NT was 2.22 ± 0.70 and 1.41 ± 0.45 in the fresh and old groups, the difference was statistically significant (P < 0.01). The tomo T/NT was 5.06±3.52 and 2.08±0.73 in the fresh and old groups, the difference was statistically significant (P < 0.01). The cut-off values of SUVmax, planar T/NT and tomo T/NT were obtained by plotting ROC curves for differential diagnosis, and the diagnostic sensitivity, specificity and diagnostic agreement of SUVmax were higher than planar T/ NT and tomo T/NT. Conclusion The standard uptake value of quantitative SPECT/CT has important reference value in the diagnosis of elderly osteoporotic spinal compression fractures, it can provide an objective basis for clinical treatment. -
Key words:
- compression fracture /
- SPECT/CT /
- quantitative analysis /
- osteoporosis /
- standard uptake value
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图 1 手动勾画靶区及非靶区并计算断层显像T/NT
Figure 1. Manually outline target and non-target areas and calculate tomo T/NT.
图 2 勾画受累椎体浓聚VOI并测量病灶SUVmax
Figure 2. Draw the concentrated VOI of the vertebrae and measure the SUVmax.
图 3 受累椎体SUVmax、平面显像T/NT及断层显像T/NT的ROC曲线
Figure 3. ROC curves of SUVmax, planar T/NT and tomo T/ NT of the vertebrae.
表 1 骨定量SUVmax、平面显像T/NT及断层显像T/NT的诊断效能对比
Table 1. Comparison of the diagnostic efficacy of bone quantification SUVmax, planar T/NT and tomo T/NT
方法 Cut-off AUC 敏感度 特异性 Kappa P SUVmax 18.500 0.997 0.983 0.979 0.943 < 0.01 平面T/NT 1.738 0.857 0.800 0.787 0.585 < 0.01 断层T/NT 2.573 0.897 0.883 0.851 0.715 < 0.01 
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