嗜铬细胞瘤定位核素诊断方法的研究进展

The radionuclide imaging methods for the diagnostic localization of pheochromocytoma

嗜铬细胞瘤的诊断和治疗很大程度上依赖于肿瘤的定位。随着分子影像学和核医学的进步,用于嗜铬细胞瘤定位的核素诊断方法有了很大的进展,包括放射性碘标记的间碘苄胍(MIBG)扫描、正电子断层显像、放射性核素标记的生长抑素类似物(如奥曲肽)扫描等。目前为止,MIBG扫描已在各临床诊疗中心普遍开展,为嗜铬细胞瘤特别是肾上腺髓质以外的嗜铬细胞瘤的定位诊断提供了简便、有效的手段。正电子断层显像方法和生长抑素类似物扫描在一些研究中能发现MIBG显像阴性的嗜铬细胞瘤病灶,与MIBG互补可增加诊断的敏感性,但两者临床经验还很少,尚待更多的研究评估。

The diagnosis and treatment of pheochromocytoma depend critically on localization of the tumor. Recently, with the advance of molecular imaging and nuclear medicine, the radionuclide imaging methods for the localization are developing greatly, including scintigraphy after administration of ^123I- or ^131I -labeled metaiodobenzylguanidine（123^I/^131I-MIBG）, positron emission tomography （PET）, the application of radiolabelled somatostatin analogue like octreotide and so on. So far, MIBG scintigraphy have been widely used in many clinical centers, as a useful measure to localize the tumor especially extra-adrenal focus conveniently. In some studies, PET and somatostatin analogue scanning both succeed in finding the small minority of pheochromocytomas that do not accumulate MIBG. They make the diagnosis more sensitive together with MIBG. However, there is little experience with PET imaging and radiolabelled octreotide scintigraphy, which need further study and evaluation.