^(67)镓显像在肺结节病的显像分析及临床应用

Diagnostic value of ^(67)Ga citrate scintigraphy for lung sarcoidosis and its clinical application

目的:探讨67镓检查在临床中对肺部结节病诊断的价值。方法:回顾性分析疑为结节病的72例患者(66例结节病,6例非结节病)67镓显像资料,并对肺部X线、CT检查和病理检查结果等临床资料进行分析。结果:66例结节病患者中,67镓检查诊断准确性为83.3%(55/66),X线、CT为78.8%(52/66),两者无显著性差异(P=0.6568)。临床诊断为结节病的12例患者,曾行病理检查无法明确诊断,行67镓检查的诊断准确性(91.7%,11/12)明显高于X线或CT检查诊断的准确性(33.3%,4/12),P=0.0114。4例病理诊断不能与增殖型结核鉴别,X线或CT检查不能明确诊断,3例67镓检查明确诊断结节病,1例67镓检查未发现有典型的结节病改变,最后诊断为肺结核。结论:67镓检查对难以明确诊断的肺结节病有一定的诊断价值。

Objective： To evaluate the diagnostic value of 67Ga citrate scintigraphy for lung sarcoidosis and its clinical application. Methods： A total of 72 patients （66 patients with lung sareoidosis and 6 patients without lung sarcoidosis but with tuberculosis） were included in this study. Their 67Ga citrate scintigraphy, chest X - ray film and CT as well as their pathological data were analyzed retrospectively. Results： The diagnostic accuracy of ^67Ga citrate planar image and X-ray film combined with CT was 83.3% （55/66） and 78.8% （52/66）, respectively. No significantly difference was found between the two methods （P = 0. 656 8 ）. Pathological examination was performed for 12 patients with lung sarcoidosis, but the results were different. The diagnostic accuracy of ^67Ga citrate planar image and X-ray film combined with CT was 91.7% （11/12） and 33.3% （4/12） , respectively. A significantly difference was found between the two methods（P = 0.011 4）. Pathological examination could not differentiate lung sarcoidosis from tubereulosis in 4 patients, which could not be definitely diagnosed by X-ray and CT. Three of the four patients were diagnosed having lung sarcoidosis by ^67Ga citrate planar image according to the pattern of “Panda Face” and the Greek letter lambda located in bilateral hilar lymph nodes, the remaining one without lung sarcoidosis was diagnosed having lung tuberculosis. Conclusion： ^67Ga scintigraphy can accurately diagnose lung sarcoidosis in patients with lung tuberculosis.