99mTc-MDP骨显像联合CT在乳腺癌术后的临床价值

99mTc-MDP bone scan combined with CT in the clinical value of breast cancer

目的探讨99mTc-MDP骨显像联合CT在乳腺癌术后早期随访中，检测其复发及转移临床价值。方法对253例术后病理确诊的乳腺癌患者一年后分别进行99mTc-MDP骨显像、CT扫描，计算灵敏度、特异性、准确性以及分析骨转移的特点。结果253例乳腺癌全身骨显像中，发现复发或转移者122例，发生率为48．2％，99mTc-MDP发现骨转移灶分布以胸部肋骨组最多见（50．9％），其次是脊柱椎体（41．8），骨盆（25．4％），四肢骨（14．5％），颅骨和其他骨骼（9．1％）；99mTc—MDP骨显像对骨转移的灵敏度、特异性、准确性分别为93．2％、90．7％、91．3％，CT扫描对复发及转移的灵敏度、特异性、准确性分别为58．2％、87．8％、73．5％。CT联合99mTc-MDP骨显像诊断复发及转移的灵敏度、特异性、准确性分别为93．4％、91．6％、92．5％。结论乳腺癌骨转移发生率很高，骨转移的发生有一定的规律及特点，99mTc-MDP骨显像联合CT可显著提高乳腺癌术后复发及转移的灵敏度、特异性及准确性，对监测其复发及转移具有重要的临床价值。

Objective To evaluate the value of clinical application of the combination of CT and 99mTc- MDP bone scan in the follow-up monitoring of cancer recurrences of the breast cancer patients previously treated with both mastecomy and chemotherapy Methods 253 female breast cancer patients treated with mastectomy and chemotherapy within the past one year were enrolled in this study. All of them underwent CT,99mTc-MDP bone scan. calculation of the sensitivity, specialty, accuracy, were analyzed. Results There were 122 patients had the bone metastasis in 253 patients diagnosed breast cancer, the incidence rate was 48.2% . The thoracic part had the most incident of osseous metastasis（50.9% ） ,then the vertebral body（41.8% ） ,pelvis（25.4% ） , limbs bone （14. 5 % ） , skull and the other parts （9. 1% ）. The sensitivity, specialty, accuracy of 99~Tc-MDP bone scan in determining osseuous metastasis were 93.2% ,90. 7% ,91.3% respectively;The sensitivity, specialty, accuracy of CT in the detection of cancer recurrence were 58. 2% ,87.8% ,73.5% respectively in CT scan. When combining 99mTc-MDP bone scan with CT scan, they were 93.4% ,91.6% ,92. 5% respectively. Conclu- sion The incidence rate of osseous metastasis is very high for the breast cancer patients, and the incidence of the osseous metastasis has definite rules and features, the combination of CT and 99mTc-MDP in the follow-up studies of the breast cancer patients previously treated with both mastectomy and chemotherapy can obtain the higher sensitivity, specialty and accuracy, making a significant contribution to the value of clinical application.