~99Tc^m-Tetrofosmin SPECT半定量分析诊断肺部肿瘤

Semi-quantitative analysis for ~99Tc^m-Tetrofosmin SPECT in diagnosis of pulmonary neoplasmas

目的评价99Tcm-TetrofosminSPECT半定量分析在判断肺部肿瘤良恶性的临床价值。方法对33例肺部肿块患者,行胸部99Tcm-Tetrofosmin显像和CT扫描,并对SPECT图像进行半定量分析。以最终的病理结果为标准,比较各组间结果。结果肺癌组的T/N值明显高于相应时相肺部良性病变组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)。其区分肺部原发性肿瘤良、恶性的灵敏度和准确性均高于CT(P<0.05,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2hRI肺腺癌组要高于肺鳞癌组(P<0.05)。结论99Tcm-TetrofosminSPECT半定量分析能准确、有效地探测肺部肿块,还可能为肺癌的组织类型提供更多的信息,在肺癌的诊断中具有重要的临床实用价值。

Objective To evaluate the clinical efficacy of semi-quantitative analysis of ^99Tc^m-Tetrofosmin SPECT in diagnosis of pulmonary neoplasmas. Methods Both CT scan and ^99Tc^m-Tetrofosmin SPECT were performed in 33 patients with pulmonary neoplasmas at one week before surgical operations or punctures. Then the nuclide images were managed with semi-quantitative analysis method, and the results of each group were compared according to the final pathological findings. Results There was marked difference in target/non-target （T/N） ratio between the lung malignancies and the benign disorders （P 〈 0.001）. Moreover,in the lung cancer group,T/N ratio in tomographies was significantly higher than that in planar images （ P 〈 0.01 ）. The sensitivity and accuracy of semi-quantitative analysis in ^99Tc^m-Tetrofosmin SPECT was remarkably higher than that of CT in diagnosis of pulmonary neeplasmas （P 〈 0.05 and P 〈 0.01 respectively）. It was also found that epidermoid squamous cell carcinomas and adenocarcinomas were beth higher than small ceil carcinomas in T/N ratio （P 〈 0.05 ）, and 2 h retention index （RI） of adenocarcinomas was higher than that of epidermoid squamous ceil carcinomas （P 〈 0.05）. Conclusion The ^99Tc^m- Tetrofosmin SPECT analyzed with semi-quantitative technology is an accurate and effective approach in differentiating lung cancers from benign pulmonary neoplasmas. Furthermore, it may be able to provide some information about histological types of the cancer tissue. Therefore,^99Tc^m-Tetrofosmin SPECT will play a useful clinical role in the diagnosis of pulmonary neoplasmas.