^(99m)Tc-MIBI显像在乳癌及腋窝淋巴结转移诊断应用

^(99m)Tc-MIBI Imaging in Diagnosis of Breast Cancer and Axillary Lymph Node Metastases

目的探讨99mTc-甲氧基异丁基异腈(MIBI)乳腺显像在诊断乳癌及腋窝淋巴结转移中的应用价值。方法80例乳房肿块患者行99mTc-MIBI乳腺平面显像,于病变乳房对侧肘静脉注射99mTc-MIBI740MBq(15～25mCi)后30min,采集胸部两侧位(俯卧位)及前后位(仰卧位)图像,乳房内和/或腋窝区出现异常放射性浓聚为阳性,分别计算肿瘤与健侧对应部位(T/N)的放射性比值,并与术后或活检病理检查结果对照。结果良性病变组30例乳腺阴性显像24例,阳性显像6例,恶性组50例中乳腺阳性显像46例,阴性显像4例,两组间比较差异有统计学意义。99mTc-MIBI乳腺亲肿瘤显像对乳腺癌诊断的灵敏度为92%,特异性为80%。99mTc-MIBI显像诊断乳腺癌腋窝淋巴结转移假阴性6例,假阳性2例,其灵敏度78.6%,特异性为90.1%,准确性为84%。结论99mTc-MIBI乳腺显像可作为诊断乳癌的方法,并对腋窝淋巴结转移的诊断有一定价值。

Objective To evaluate the clinical value of 99mTc-MIBI imaging in differentiating benign from malignant breast tumors and in detecting axillary lymph node metastases. Methods 99mTc-MIBI scintimammography were performed in 80 women with palpable breast lesions. Two lateral (prone imaging) views and one anterior (supine) planar view were obtained 30 min after intravenous injection of 740 MBq (15～25mCi) 99mTc-MIBI.The T/N ratio of the average counts in the tumor over the average counts in the contral alteral ROI was calculated, Comprarative diagnosis was done by postoperative or biopsy pathology in all cases. Results Of the 80 cases, there were 46 true-positive , 4 false-negative in 50 malignants imaging and 24 true-negative and 6 false-positive in 30 benign. The sensitivity of 99mTc-MIBI images in diagnosis of breast cancer was 92%, and the specificity was 80%。 By diagnosis of 99mTc-MIBI imaging,axillary lymph node metastasis false-negative 6 cases, false-positive 2 cases.The sensitivity of scintimammograph in detecting metastatic axillary lymph node was 78.6%, and the specificity was 90.1%,the accuracy was 84%. Conclusion 99mTc-MIBI scintigraphy of breast lesions is an effective means of differentiating benign from malignant lesions and in detecting axillary lymph node metastases.