乳腺肿块^(99)Tc^m-MIBI双时相断层显像与X线钼靶对照研究

Comparative study with double-phase ^(99)Tc^m-MIBI tomographic imaging and mammography in diagnosis of breast lesions

目的:分析比较99Tcm-甲氧基异丁基异腈(MIBI)双时相断层显像与钼靶X线摄影法对乳腺肿块的临床诊断价值。方法:对93例女性乳腺肿块患者术前1周行99Tcm-MIBI双时相断层和X线钼靶摄影检查,以术后病理结果为金标准,判断以上2种方法在乳腺癌早期诊断中的灵敏性、特异性、准确性、阳性预测值及阴性预测值。结果:①99Tcm-MIBI乳腺双时相断层显像示:良性病变早期和延迟相T/NT比值为2.08±2.85和1.69±3.05,两者有显著性差异(P<0.05);乳腺癌早期和延迟相T/NT比值为5.00±4.34和6.79±11.94,两者无显著性差异(P>0.05)。②99Tcm-MIBI乳腺肿块双时相断层显像诊断乳腺癌的敏感性为97.1%,特异性为94.8%,准确性为95.7%,阳性预测值为91.9%,阴性预测值为98.2%;X线钼靶诊断乳腺癌的敏感性为82.9%,特异性为70.7%,准确性为75.3%,阳性预测值为63.0%,阴性预测值为87.2%;2种方法对乳腺癌的诊断效能有显著性差异(P<0.05)。结论:99Tcm-MIBI双时相断层显像对乳腺癌的诊断效能优于X线钼靶摄影法。99Tcm-MIBI乳腺双时相断层显像是一种高灵敏性和特异性的乳腺癌检查方法,对鉴别乳腺良恶性病变有较高的临床价值。

Objective： To evaluate the value of double-phase ^99 Tc^m-MIBI tomographic imaging and mammography in diagfiosis of breast lesions. Methods： Double-phase ^99Tc^m-MIBI tomographic imaging and mammography were performed within one week for patients with breast neoplasms. The final diagnosis were verified with histological examination. Result： （1）The TINT ratios of early and delayed imaging were 2.08±2.85 and 1.69±3.05 in benign lesions, There was significant difference （P〈0.05）. The TINT ratios of early and delayed imaging were 5.00±4.34 and 6.79±11.94 in malignant tumors, there was no significant difference（P〉0,05）. （3）The sensitivity of double-phase ^99 Tc^m-MIBl tomographic imaging in diagnosis of breast cancer was 97.1%; specificity was 94.8%; accuracy was 95.7%; the positive predictive value was 91.9%, and the negative predictive value was 98.2%. The sensitivity of mammography in diagnosis of breast cancer was 82.9% and specificity 70,7% and accuracy 75.3% and the positive predictive value 63,0% and the negative predictive value 87.2%, the two methods showed significant difference（P〈0.05）. Conclusion： The double-phase ^99Tc^m-MIBI tomographie imaging is superior to the mammography in diagnosing breast cancer, double-phase ^99Tc^m-MIBI tomographic imaging has higher sensitivity and specificity in the diagnosis of breast cancer, It is an effective means in differentiating benign from malignant lesions.