^(99)Tc^m-MIBISPECT/CT同机融合断层显像对肺癌及其转移淋巴结的诊断价值

The value of^(99) Tc^m-MIBI SPECT/CT fus ion imaging for the diag nosis of the lung neoplasm and metastatic lymph node

目的 :探讨99Tcm MIBISPECT/CT同机融合断层显像对肺癌及其转移淋巴结的诊断价值。方法 :以术后病理诊断为依据 ,对 5 7例肺部占位性病变患者的99Tcm MIBISPECT/CT显像结果分良性和肺癌两组进行分析 ,计算其 5min、6 0min平面以及 6 0minSPECT/CT三维融合断层显像的摄取比值 (UR) ;以肺部良性病灶组UR值的 x +1s为诊断阈值 ,对肺癌原发灶及其转移淋巴结的诊断效能进行评价。结果 :17例肺部良性病灶组其 5min和 6 0min平面以及 6 0minSPECT/CT三维融合断层显像的摄取比值 (UR)分别为 1.0 5± 0 .16、0 .97± 0 .2 2、1.5 1± 0 .39,而 4 0例肺癌组其UR值分别为 1.4 1± 0 .2 2、1 37± 0 .2 3、2 .18± 0 .6 1同组两时相比较P >0 .0 5 ,而组间两时相比较P <0 .0 5。以良性结节 x +1s为诊断阈值 ,99Tcm MIBI对肺癌诊断的灵敏度、特异度和准确度分别为 90 % (36 / 4 0 )、82 .35 % (14 / 17)和 87.72 % (5 0 / 5 7) ;假阳性率和假阴性率分别为 17.6 5 % (3/ 17)和 10 % (4 / 4 0 ) ;阳性预测值和阴性预测值分别为 92 .31% (36 / 39)和 77.78% (14 / 18)。 4 0例恶性病变患者共检出转移淋巴结 19个 ,其CT/SPECT断层融合图像的UR值为 1.82± 0 .37。结论 :99Tcm MIBISPECT/CT同机融合断层显像对肺癌及其转?

Objective:To study the value of 99 Tc m-MIBI SPECT/CT real-ti me fusion imaging for the diagnosis of the lung neoplasm and metastatic lymph no de.Methods:The 99 Tc m-MIBI ima ging results, which was divided into two groups of lung cancer and benign one by the post-operation pathologic results, were analyzed in 57 cases of lung occupied lesion.The uptake ratio (UR) was calc ulated at time of 5 min,60 min planer and 60 min SPECT/CT fusion imaging after 99 Tc m-MIBI injection.The efficacy of 99 Tc m-MIB I SPECT/CT real -time fusion imaging for the diagnosis of the lung neoplasm and metastatic lymp h node was analyzed by the threshold of +1s of the lung benign grou p.Results:T he UR value of 17 cases of the lung benign group was 1.05±0.16,0.97±0.22 and 1 .51±0.39 respectively at the time of 5 min, 60 min planer and 60 min SPECT/CT f usion imaging, while 40 cases of malignant group was 1.41±0.22,1.37±0 23 and 2 .18±0.61 respectively.There was a significant UR difference in two groups at tw o phases (P<0.05). Using the +1s of benign group UR value as di agnostic threshold.The sensitivity、specificity and a ccuracy of 99 Tc m-MIBI imaging for the lung occupied lesions was 90%(36/ 40),82.35%(14/17) and 87.72%(50/57) respectively.The false positive and false ne gative rate were 17.65%(3/17) and 10%(4/40).The positive and negative predictive value were 92.31%(36/39) and 77.78%(14/18). 19 metastatic lymph nodes were det ected in 40 cases of malignant group. The mean UR value of the lymph nodes was 1 .82±0.37.Conclusion: 99 Tc m-MIB I SPECT/CT real-time fusion imaging h as a good value for the diagnosis of the lung neoplasm and metastatic lymph node .