Objective:To analyze the 99 Tcm-methylene diphosphonate single photon emission computed tomography/spiral computed tomography (SPECT/CT)fusion imaging of bone metastases in patients with lung cancer and to evaluate the value of SPECT/CT in differentiating metastases from benign bone lesions.Methods:A total of 113 patients with bone metastases from lung cancer confirmed by pathology underwent bone scintigraphy and SPECT/CT imaging.Metastatic bone sites,quantity,up-take of radiotracer,and CT manifestations of each lesion were analyzed via bone scintigraphy imaging and SPECT/CT fusion imaging.Results:A total of 482 lesions from 113 patients were analyzed in this study.Among them,429 lesions were metasta-ses.Metastatic sites included spine(50.6%),thorax (29.1% ),pelvis (17.0%),extremities (2.1%),and skull(2.1%).CT manifestations were osteoblastic (41.0%),osteolytic (50.3%),mixed (4.0%),and normal (4.7%).Among these lesions, the proportion of hot spots displayed on SPECT/CT pictures was 90.7%(389/429),and the proportion of lesions with normal uptake of radiotracer was 9.3%(40/429).There were 53 benign lesions in 23 patients with bone metastasis.Conclusions:The most frequent metastatic sites in patients with lung cancer are spine and thorax.Bone metastasis from squamous carcinoma is more com-mon than from other types of lung cancer.The common CT manifestations are osteoblastic.The sensitivity and specificity of SPECT/CT fusion images for the diagnosis of bone metastatic lesions of lung cancer are high.%目的：探讨99 Tcm-亚甲基二膦酸盐（methylene diphosphonate，MDP）单光子发射计算机断层／CT（single photon emis-sion computed tomography／ spiral computed tomography，SPECT／CT）所显示的肺癌骨转移病灶的图像特点及 SPECT／CT 显像对肺癌骨转移的诊断价值。方法：回顾分析113例病理证实为肺癌、初次全身骨显像及 SPECT／CT 显像诊断为肺癌骨转移的患者的骨转移病灶的 SPECT／CT 图像特点，经病理诊断或再次全身骨显像及 SPECT／CT 显像随访确认，分析 SPECT／CT 显像所示肺癌骨转移病灶的部位、数量、放射性分布及 CT 表现的特点。结果：113例患者共482处病灶纳入本研究，肺癌骨转移病灶429处。肺癌骨转移病灶中位于脊柱者占50．6％（217／429），胸廓者占29．1％（125／429），骨盆者占17．0％（73／429），四肢者占2．1％（9／429），颅骨者占1．2％（5／429）。肺癌骨转移病灶 SPECT／CT 图像表现为放射性异常浓聚者占90．7％（389／429），无放射性分布异常者占9．3％（40／429）；CT 图像表现为成骨性转移者占41．0％（176／429），溶骨性转移者占50．3％（216／429），混合性（兼有溶骨和成骨）转移者占4．0％（17／429），骨质形态学正常者占4．7％（20／429）。113例患者中有23例患者同时伴有良性病灶，共53处。结论：肺癌骨转移的部位以脊柱居首，胸廓次之；肺腺癌患者容易发生骨转移，以成骨性转移多见。SPECT／CT 诊断肺癌骨转移病灶的敏感度和特异性均较高。
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