Objective To compare and evaluate the clinical value of multi-modal imaging of 18 F-FDG coincidence imaging , 99m Tc-MDP whole body bone scan and MRI in detection of spinal metastasis .Methods A retro-spective analysis of 72 patients with biopsy-proven malignancy was conducted and suspected bone metastases underwent 99m Tc-MDP planar bone scintigmphy . Then, we performed 18F-FDG immediately and MRI within 2 weeks apart.The diagnostic results were confirmed by biopsy /pathol-ogy, MRI/CT and clinical follow-up for more than six months.The result of 18F-FDG coincidence imaging, 99mTc-MDP wholebody bone scan and MRI were compared .χ2 test was used for statistical analysis .Results Fifty-six of 72 patients were proved to have bone metastases and 120 foci were demonstrated as metastatic lesions.18F-FDG had a sensitivity of 87.5%(49/56), a specificity of 81.3%(13/16) and an accuracy of 86.1%(62/72) for diangnosis of bone metastases; whereas the values for 99mTc -MDP bone scanning were 85.7%(48/56), 75.0%(12/16) and 83.3%(60/72), respectively.MRI were 94.6%(53/56), 87.5%(14/16) and 93.1%(67/72), respectively.They were not significantly different (all P >0.05), The detection rate of 120 posi-tive bone metastases vertebral were 86.7%(104/120), 70.0%(84/120) and 93.3%(112/120), respectively.The diagnostic value of 99mTc-MDP bone scanning were significantly different for 18F-FDG coincidence imaging and MRI (both P <0.01).18F-FDG coincidence imaging and MRI were not significantly different ( P >0.05).Conclusion The 99mTc-MDP bone scanning has been usually used as the imaging modality of choice in the clinical screening for bone metastasis .The diagnostic accuracy of 18 F-FDG coincidence imaging and MRI in detecting bone metastases of spine are both better than 99mTc-MDP bone scan.They are all valuable for detecting bone metastases of spine as a further and complementary assessment of bone scan .%目的：探讨多模式影像18 F-FDG符合显影、99m Tc-MDP骨显影及MRI在脊柱转移瘤的临床价值。方法临床拟诊恶性肿瘤或肿瘤术后复发患者72例行常规99m Tc-MDP全身骨显像，同期（2周内）行18 F-FDG符合显影和MRI。回顾性分析患者临床资料，以病理结果或两种以上影像技术（ MRI、CT等）结果或随访6个月以上结果为最终结果，比较18 F-FDG符合显影、99m Tc-MDP骨显像与MRI的诊断结果，每两种方法间采用卡方检验分析各自结果。结果72例患者中56人有脊柱转移，共探测到120个椎体转移，18 F-FDG符合显像探测脊柱转移瘤灵敏度为87．5％（49／56），特异性为81．3％（13／16）和准确性为86．1％（62／72）；99mTc-MDP骨显像分别为85．7％（48／56），75．0％（12／16）和83．3％（60／72）；MRI分别为94．6％（53／56）；87．5％（14／16）和93．1％（67／72）。三种方法间比较差异无统计学意义（ P均＞0．05）；三种方法在120个转移瘤椎体的检出率分别是86．7％（104／120）、70．0％（84／120）和93．3％（112／120），99m Tc-MDP骨显像与18 F-FDG符合显像和MRI诊断价值差异有统计学意义（ P均＜0．01），18 F-FDG符合显像和MRI对比差异无统计学意义（ P＞0．05）。结论99m Tc-MDP骨显像一次成像便于整体评价全身骨病变，在肿瘤脊柱转移的筛查中仍是首选方法，18 F-FDG符合显影与MRI起鉴别诊断和重要补充的作用，均有较高的临床价值。
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