^(99)Tc^-mTetrofosmin胸部显像诊断肺部肿瘤的临床研究

^(99)Tc^m-Tetrofosmin imaging in diagnosis of lung neoplasms

目的 评价99Tcm Tetrofosmin(TF)胸部显像在诊断肺部肿瘤及纵隔淋巴结转移中的临床应用价值。方法 对33例肺部肿块患者(肺癌23例,肺部良性疾病10例)行胸部 Tc TF显像和CT扫描,并对SPECT图像进行半定量分析,比较各组间结果。结果 99 Tcm TF胸部显像区分肺部原发性肿瘤良、恶性及其诊断纵隔淋巴结转移的灵敏度均高于 CT(P<0.05)。肺癌组的靶/非靶(T/N)值明显高于相应的肺部良性病变组 T/N值(P<0.001);且肺癌组断层显像的 T/N值明显高于平面显像(P<0.01)。肺鳞癌组和肺腺癌组的T/N值均高于小细胞肺癌组(P<0.05);而2 h滞留分数(RI)肺腺癌组要高于肺鳞癌组(P<0.05)。结论 99Tcm TF能准确、有效地探测肺癌的原发灶和纵隔淋巴结转移灶,利用半定量方法能提高其准确性,还可能为肺癌的组织类型提供更多的信息,在肺癌的诊断和分期中具有重要的临床实用价值。

Objective To evaluate the clinical value of chest imaging using ^(99)Tc^m-Tetrofosmin (TF) in diagnosing lung cancer and mediastinal lymph node metastases. Methods Thirty-three cases including 23 lung cancer cases and 10 cases of benign lesions took both computed tomography (CT) and ^(99)Tc^m-TF single photon emission computed tomography (SPECT) in one week before their operations or acupunctures. Then the images were managed with half-quantitative analysis method, and the results of each group were compared. Results The sensitivity of ^(99)Tc^m-TF SPECT was significantly higher than that of CT in the diagnosis of lung cancer (P<0.05) and mediastinal lymph node metastases (P<0.01). There was marked difference in target/non-target (T/N) ratio between the lung cancer patients and the benign(P<0.001). Moreover, in the lung cancer group, T/N ratio in tomographies was significantly higher than that in planer images (P<0.01). It was also found that there was no difference in T/N ratio between epidermoid squamous cell carcinomas and adenocarcinomas (P>0.05), but they were both higher than small cell carcinomas (P<0.05), and 2 h retention index (RI) of adenocarcinomas was higher than that of epidermoid squamous cell carcinomas (P<0.05). Conclusion ^(99)Tc^m-Tetrofosmin SPECT is an accurate and effective method in evaluating lung cancers and mediastinal lymph node metastases. And half-quantitative technology can improve its accuracy and may provide some information about histology type of the cancer tissue. Therefore, ^(99)Tc^m-Tetrofosmin SPECT will be a useful tool in the diagnosis and stage of lung cancer.