Epsom and St. Helier University Hospital NHS Trust, Wrythe Lane, Carshalton SM5 1AA, United Kingdom.
Foot Ankle Surg. 2013 Jun;19(2):80-3. doi: 10.1016/j.fas.2012.11.002. Epub 2012 Dec 29.
A radionuclide bone scan with single photon-emission computed tomography and CT (SPECT-CT) is a new imaging modality which combines highly detailed CT with the functional information from a triple phase radionuclide bone scan. Little has been published about its diagnostic accuracy and usefulness in foot and ankle pathology. The aim of this study is to evaluate whether bone scans with SPECT-CT provide a useful contribution to the management of patients with foot and ankle pain, and whether it results in changes to clinical management.
A retrospective study involving 50 patients was conducted between March 2010 and April 2011. SPECT-CT was requested in cases where definitive clinical diagnosis could not be achieved after clinical examination and plain radiography. Pathology as highlighted on SPECT-CT was taken as the definitive diagnosis in these patients and was treated accordingly. Patients were subsequently seen in the follow up clinic to evaluate the outcome of their treatment.
In 11 patients (22%), the provisional clinical diagnosis matched with the findings of the SPECT-CT and no change in treatment was necessary. In 39 patients (78%) the findings of the SPECT-CT did not correlate exactly with the initial clinical diagnosis and led to a modified treatment plan. The accuracy, sensitivity, specificity, positive predictive and negative predictive value of SPECT-CT in this series was 94%, 95.45%, 83.3%, 97.6% and 71.43% respectively.
SPECT-CT is a useful investigation tool in foot and ankle pathologies. The present study shows a high diagnostic accuracy and we recommend its use in cases with diagnostic uncertainty.
单光子发射计算机断层扫描和 CT（SPECT-CT）放射性核素骨扫描是一种新的成像方式，它将高度详细的 CT 与三相放射性核素骨扫描的功能信息相结合。关于其在足踝病理学中的诊断准确性和实用性，发表的内容很少。本研究旨在评估 SPECT-CT 骨扫描是否为足踝疼痛患者的管理提供有用的帮助，以及是否会改变临床管理。
2010 年 3 月至 2011 年 4 月期间进行了一项回顾性研究，共纳入 50 例患者。在临床检查和普通 X 线摄影后无法明确诊断的情况下，请求进行 SPECT-CT 检查。这些患者的 SPECT-CT 阳性结果被视为明确诊断，并进行相应治疗。随后，患者在随访诊所就诊，评估其治疗效果。
在 11 例（22%）患者中，初步临床诊断与 SPECT-CT 结果相符，无需更改治疗方案。在 39 例（78%）患者中，SPECT-CT 结果与初始临床诊断不完全一致，需要修改治疗计划。本研究中 SPECT-CT 的准确性、敏感度、特异度、阳性预测值和阴性预测值分别为 94%、95.45%、83.3%、97.6%和 71.43%。
SPECT-CT 是足踝病变的一种有用的检查工具。本研究显示其具有较高的诊断准确性，我们建议在诊断不确定的情况下使用 SPECT-CT。
