目的：探究¹⁸F-FDG PET/CT在椎体良、恶性病变诊断及鉴别中的临床应用价值,并与MRI对比。方法：回顾性搜集2014年12月至2020年8月于本院先后行MRI、¹⁸F-FDG PET/CT检查以脊柱椎体病变为主的87例患者资料，通过活检、术后病理或随访及相关影像检查获得最终临床诊断作为金标准，计算两种显像方法诊断的准确性、灵敏度、特异度、阳性预测值、阴性预测值；比较是否存在差异。分别计算并比较良、恶性组的SUVmax，绘制受试者工作特征(ROC)曲线分析其诊断效能。结果：患者年龄 20~92岁，44例为恶性，43例为良性。PET/CT诊断的灵敏度、阴性预测值高于MRI(95.5%vs.79.5%，94.7%vs.81.3%)，差异有统计学意义(均P<0.05)，两种方法准确性、特异度、阳性预测值间差异无统计学意义(P>0.05)。PET/CT的ROC曲线下面积(AUC)为0.896， MRI为 0.851，两者间差异无统计学意义(Z=1.177，P=0.239)。椎体恶性组的SUVmax为8.71±4.59，高于良性组的6.04±3.91，差异具有统计学意义(P<0.05)。在区分恶性组和良性组的诊断效能中，SUVmax的AUC为0.711。结论：¹⁸F-FDG PET/CT作为MRI的有力补充，对于椎体病变的定性诊断及鉴别也具有较高的准确性、敏感性，有助于病变精确诊断。

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