Li Yong-Bo, Zheng Xi, Wang Rui, Wu Han, Han Shuo, Deng Zhi-Yang, Sun Dong
Departments of Orthopedics.
Department of Obstetrics and Gynecology, Yanbian Hospital, Yanbian University, Yanbian, China.
Nucl Med Commun. 2018 Jul;39(7):610-617. doi: 10.1097/MNM.0000000000000857.
This study aimed to evaluate the difference and consistency between single-photon emission computed tomography-computed tomography (SPECT-CT) and MRI in diagnosing osteoporotic vertebral compression fractures (OVCFs) and identifying active lesions.
All 46 patients underwent SPECT-CT and MRI examinations. The pain vertebral body and pain sites were determined using both MRI and SPECT-CT during percutaneous kyphoplasty (PKP). The differences before and after treatment were assessed using visual analog scale scores and evaluated using a paired t-test. Furthermore, the difference and conformity of SPECT-CT and MRI in diagnosing OVCFs were determined using the McNemar test and the κ-statistic, and by calculating the accuracy index of SPECT-CT diagnosis.
Among all 46 patients, MRI showed 79 segments that fulfilled the diagnostic criteria for fresh OVCFs, whereas SPECT-CT showed 83 segments, and a total of 77 affected vertebral bodies were treated with PKP. Paired t-test evaluation showed that PKP was effective, suggesting that the affected sites were determined accurately (P<0.05). Furthermore, the κ-statistics indicated that these two methods were highly consistent (P<0.05) and the McNemar test indicated that the efficacy of these two diagnostic methods was closely correlated (P>0.05). In different stages of fractures, especially the acute phase, the consistency of SPECT-CT and MRI in the diagnosis of fresh OVCFs was high.
SPECT-CT is the preferred method for imaging diagnosis when patients with suspected OVCFs have contraindications to MRI, particularly for patients with acute fractures.
本研究旨在评估单光子发射计算机断层扫描-计算机断层扫描（SPECT-CT）与磁共振成像（MRI）在诊断骨质疏松性椎体压缩骨折（OVCFs）及识别活动性病变方面的差异和一致性。
46例患者均接受了SPECT-CT和MRI检查。在经皮椎体后凸成形术（PKP）期间，使用MRI和SPECT-CT确定疼痛椎体和疼痛部位。采用视觉模拟量表评分评估治疗前后的差异，并使用配对t检验进行评估。此外，使用McNemar检验和κ统计量，并通过计算SPECT-CT诊断的准确性指数，确定SPECT-CT与MRI在诊断OVCFs方面的差异和一致性。
在所有46例患者中，MRI显示79个节段符合新鲜OVCFs的诊断标准，而SPECT-CT显示83个节段，共有77个受累椎体接受了PKP治疗。配对t检验评估显示PKP有效，提示受累部位确定准确（P<0.05）。此外，κ统计量表明这两种方法高度一致（P<0.05），McNemar检验表明这两种诊断方法的疗效密切相关（P>0.05）。在骨折的不同阶段，尤其是急性期，SPECT-CT与MRI在诊断新鲜OVCFs方面的一致性较高。
当疑似OVCFs的患者存在MRI检查禁忌证时，SPECT-CT是成像诊断的首选方法，尤其是对于急性骨折患者。
