^(99m)Tc-MIBI肺癌三维立体显像的临床价值

Clinical value of three-dimensional visualization of lung cancer by ^(99m)Tc-MIBI

目的:探讨(99m)~Tc-MIBI三维立体显像对肺癌患者的临床应用价值。方法:对30例肺占位病变的患者,采用PHILIPS公司FORTE-AZ SPECT仪进行采集,配以低能高分辨准直器。均行(99m)~Tc-MIBI早期和延迟肺显像,断层采集矩阵64×64,每帧40 s,zoom 1.5,采集64帧,获得三维影像并进行三维动态显示;同时,测定病变靶/非靶摄取比值和肿瘤滞留指数。结果:研究结果表明,三维显示对诊断肺部恶性病变优于平面显像法,其灵敏度90.0%,特异性80.0%,准确率86.6%。肺良性病变患者早期及延迟显像的病变靶/非靶摄取比值分别为1.19±0.27和1.13±0.19;肺癌患者分别为1.49±0.23和1.45±0.21,肿瘤滞留指数>0。肺癌化疗前早期显像和延迟显像的病变靶/非靶摄取比值和肿瘤滞留指数均明显高于治疗后的相应值。结论:(99m)~Tc-MIBI三维立体显像法可提高肺癌阳性显像的分辨力,更好地进行空间定位,提高肺癌原发病灶及其在相邻的部位转移灶检出率,是一项实用性较强的肺癌辅助检查手段。同时也是监测肺癌复发与评价肺癌化疗效果的有效方法。

Objective： to discuss the clinical value of three - dimensional visualization of lung cancer by^99mTc-MIBI. Method： Among 30 eases of patients with lung lesion, FORTE-AZ SPECT from PHILIPS was used to collect samples together with low - engine high resolution collimator. We took both early and delayed lung imaging by^99mTc-MIBI, collected matrix 64 ＊ 64 by fault, using 40s per frame, zoom 1.5. Then we got 3 - dimensional image to process 3 - dimensional dynamic display by 64 frames. Meantime, we determined the absorbent ratio and tumor stagnation index of process target/ non - target. Results： The findings indicate that it is better to use three - dimensional display to diagnose the malignant process than to use planar imaging. The sensitivity of three - dimensional display was 90.0 %, and the specificity was 80.0 %, and the accurate rate was 86.6 % . The process target/non - target absorbent ratio of patients with lung benign lesion in early and delayed imaging was about 1.19 ± 0.27 and 1.13 ± 0.19 respectively. For patients with lung cancer, it was about 1.49 ± 0.23 and 1.45 ± 0.21, and the tumor stagnation index was greater than 0. The absorbent ratio and tumor stagnation index of process target/non-target of the early imaging and delayed imaging before chemotherapy are obvious higher than post - treatment corresponding value. Conclusion： ^99mTc-MIBI three - dimensional visualization can improve the resolving power of masculine imaging of lung cancer. It has better space allocation function, and it can improve the detection rate of lung cancer primary lesion and its metastasis within consecutive parts. It is a strongly applicable method of auxiliary examination of lung cancer. Meantime, it is an effective method to monitor the recidivation of lung cancer and to evaluate the effectiveness of chemotherapy.