Andersen Julie Bjerglund, Mortensen Jann, Bech Birthe Højlund, Højgaard Liselotte, Borgwardt Lise
Department of Clinical Physiology, Nuclear Medicine, Rigshospitalet, Copenhagen University Hospital, Denmark.
Nucl Med Commun. 2011 May;32(5):356-62. doi: 10.1097/MNM.0b013e328342823d.
This study evaluates the diagnostic value of single photon emission computed tomographic (SPECT)/multislice computed tomographic (MSCT) fusion images compared with planar scintigraphy in children.
Fifteen children [eight girls, mean age 13 years (range 2-17 years)] who were examined in the SPECT/16-MSCT scanner at the Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet were included. The studies and clinical indications were eight Tc-hydroxymethane diphosphonate bone scintigraphies (three bone abnormalities, three osteomyelitis, two bone tumours), one bone scintigraphy combined with In-labelled leukocyte study (osteomyelitis), three I-meta-iodobenzylguanidine scintigraphies (neuroblastoma), three In-octreotide scintigraphies (two carcinoid tumours, one Langerhans cell histiocytosis) and one Tc-dimercaptosuccinic acid scintigraphy (suspected renal transplant infarction). At the evaluation of the planar scans, the decision to perform a SPECT/16-MSCT scan was taken. A specialist in nuclear medicine read the SPECT scans and the CT scans were, if performed as high resolution or when in doubt, read by the specialist in radiology, followed by a simultaneous reading. We categorized the additional information gained from the SPECT/MSCT scan into three groups: (i) structural information gained from the CT scan, (ii) additional nuclear medicine information gained from the SPECT scan and (iii) information used for biopsy guidance. Use of a CT scan of diagnostic quality was only allowed (n = 1) after referral from the clinicians, and read in collaboration with the specialist in radiology.
Fourteen of the 15 planar scans gained additional structural information from SPECT/CT. Twelve of 15 planar scans gained additional nuclear medicine information. Six studies gained specific information for biopsy guidance.
SPECT/CT provided additional information in all cases. SPECT/CT in children seems to be a most valuable tool and it increases the certainty of the diagnostic work-up.
本研究评估单光子发射计算机断层扫描（SPECT）/多层计算机断层扫描（MSCT）融合图像与平面闪烁扫描术相比在儿童中的诊断价值。
纳入了在里格霍斯皮塔尔临床生理学、核医学与正电子发射断层显像科的SPECT/16-MSCT扫描仪上接受检查的15名儿童[8名女孩，平均年龄13岁（范围2 - 17岁）]。研究及临床指征包括8例锝-羟基甲烷二膦酸盐骨闪烁扫描（3例骨异常、3例骨髓炎、2例骨肿瘤）、1例骨闪烁扫描联合铟标记白细胞研究（骨髓炎）、3例碘-间碘苄胍闪烁扫描（神经母细胞瘤）、3例铟-奥曲肽闪烁扫描（2例类癌肿瘤、1例朗格汉斯细胞组织细胞增多症）以及1例锝-二巯基丁二酸闪烁扫描（疑似肾移植梗死）。在评估平面扫描时，决定进行SPECT/16-MSCT扫描。核医学专家解读SPECT扫描，CT扫描如果是高分辨率扫描或存在疑问时，由放射科专家解读，随后进行联合解读。我们将从SPECT/MSCT扫描获得的额外信息分为三组：（i）从CT扫描获得的结构信息，（ii）从SPECT扫描获得的额外核医学信息，（iii）用于活检引导的信息。仅在临床医生转诊后才允许使用具有诊断质量的CT扫描（n = 1），并与放射科专家合作解读。
15例平面扫描中有14例从SPECT/CT获得了额外的结构信息。15例平面扫描中有12例获得了额外的核医学信息。6项研究获得了用于活检引导的特定信息。
SPECT/CT在所有病例中均提供了额外信息。儿童SPECT/CT似乎是一种非常有价值的工具，它提高了诊断检查的确定性。
