核素亲肿瘤显像、CT及MRI检查诊断鼻咽癌放疗后复发的价值分析

The value of nuclein tumoraffin imaging,computed tomography and magnetic resonance imaging in the diagnosis of recurrent nasopharyngeal carcinoma after radiotherapy

目的评价99mTc-M IB I亲肿瘤显像、CT及MR I检查诊断鼻咽癌放疗后复发的价值。方法78例鼻咽癌放疗后患者经病理活检和随访证实局部复发38例,局部纤维化40例。所有患者行99mTc-M IB I亲肿瘤显像、CT及MR I检查,分析3种方法的诊断效能。结果99mTc-M IB I亲肿瘤显像灵敏度(73.7%)低于CT(94.7%)和MR I(92.1%),但特异性(92.5%)明显高于CT(62.5%)和MR I(67.5%)。3种方法诊断的准确率比较差异无统计学意义。3种方法联合诊断的灵敏度、特异性和准确率分别为97.4%、95%和96.2%。结论99mTc-M IB I亲肿瘤显像诊断鼻咽癌放疗后复发具有较高的特异性,可以弥补CT、MR I检查假阳性率高的缺点,3种方法联合可明显提高诊断的准确性。

Objective To evaluate the value of ^99mTc-MIBI tumoraffin imaging, computed tomography（CT）and magnetic resonance imaging （MRI） in the diagnosis of recurrent nasopharyngeal carcinoma （NPC） after radiotherapy. Methods The ^99mTc-MIBI tumoraffin imaging, CT and MRI were performed in 78 NPC postradiotherapy patients, including 38 patients with local recurrence and 40 patients with radiofibrosis confirmed by pathology and follow-up. Results The sensitivity of ^99mTc-MIBI tumoraffin imaging （73.7%） was lower than that of CT （94.7%） and MRI （92. 1% ）. The specificity of ^99mTc-MIBI tumoraffin imaging （92.5%） was obviously higher than that of CT （62. 5% ） and MRI （67.5%）. There was no significant difference in the accuracy between three imaging examination methods. The sensitivity, specificity and accuracy of the combination of three imaging examination methods in the diagnosis of recurrent NPC after radiotherapy were 97.4%, 95% and 96. 2%, respectively. Conclusion The ^99mTc-MIBI tumoraffin imaging has higher specificity in the diagnosis of recurrent NPC after radiotherapy. The diagnostic accuracy may be further improved with the combination of three methods.