^(99m)Tc-MIBI与^(99m)Tc-PPM肺肿瘤阳性显像的对比研究

Compare the effectiveness of scintigraphy in technetium-99m-sestamibi with in technetium-99m-peplomycin in patients with benign and malignant lesion in the lung

目的：对比分析99mTc-甲氧基异丁基异睛（MIBI）与99mTc-培普利欧霉素（PPM）肺肿瘤显像的特点与诊断效能。方法：对48例使用99mTc－MIBI与39例使用99Tc－PPM肿瘤阳性显像的结果通过目测观察，T／N（肿瘤与非肿瘤）比值测定，储存指数RI测定，延迟显像摄取指数DUI测定并对其结果进行对比。结果：目测观察，99mTc－MIBI显像对恶性肿瘤诊断的灵敏度为94．12％（32／34），特异性为85．71％（12／14），99mTc－PPM显像对恶性肿瘤诊断的灵敏度为90.91％（30／33），特异性为83．33％（5／6），两者之间无显著性差异（P＞0．05）；99mTc－MIBI在恶性肿瘤组早期T／N为1．36,晚期T／N为1．37，RI值为0．74DUI值为1．38，而99mTc-PPM在恶性肿瘤组分别为1．13，1．3611．77及1．64，其中两组早期T／N之间，晚期T／N之间均无显著性差异（P＞0．05），两组RI值之间有非常显著性差异（P＜0．01），两组DUI之间有显著性差异（P＜0．05）；两种显像剂在良性病变组各参数之间的差异均无显著性（P＞0.05）。结论：99mTc-L－MIBI及99mTc－PPM肺肿瘤阳性显像对肺肿瘤的诊断及鉴别其良恶性有一定价值；恶性肿瘤对两种显像剂的外排存在差异。

Objective: To compare the effectiveness of scintigraphy in technetium - 99m - sestamibi (MIBI) with in technetium - 99m -peplomycin(PPM) in patients with benign and malignant lesion in the lung.Methods: The scintigraphy was performed with technetium99m-MIBI in 48 patients and technetium - 99m - PPM in 39 patients with pulmonary lesions .In this study, the imagin results were analyzed and the early and delayed tumor - to - normal lung uptake raio(T/N)were measaured and the retention index(RI) and the delayed uptake index(DUI) were calculated.Then above Parameters were compared between in technetium - 99m - MIBI and in technetium - 99m -PPM. Results: The sensitivity, specificity and accuuacy for technetium - 99m - MIBI scintigraphy were 94. 12%, 85. 71 % and 91. 67%, fortechnetium - 99m - PPM scintigraphy 90. 91 %, 83. 33% and 89. 74%. There was no significant difference in the sensitivity, specificity andaccuracy among the two scintigraphys(P > 0. 05). In malignant lesion group, the early T/N, delayed T/N, RI and DUI for technetium -99m - MIBl scintigraphy were 1. 36, 1. 37, 0. 74 and 1. 38, for technetiam - 99m - PPM scintgraphy 1.13, 1. 36, 11. 77 and 1. 64. Therewas no significant difference in the early T/N and delayed T/N among the two scintigraphys(P > 0.05) and there was significant low in RI (P< 0. 01) and DUI (P < 0. 05)for technetium - 99m - MIBI scintigraphy that wer compared with those for technetium - 99m - PPM scintigraphy. In the benign lesion group, there was no significant difference in the early T/N, delayed T/N, RI and DUI between in technetium -99m - MIBI scintigraphy and in technetitun - 99m - PPM scintigraphy(P > 0. 05). Conclusions: The both scintgraphys in technetium -99m - MIBl and in technetium - 99m - PPM seem to be good candidaet for noninvasive methods to diagnose pulmonary neoplasm and to distinguish between benign and malignant lesion in the lung.Some lung neoplasm cells extruded more technetium - 99m - MIBI than technetium - 99m - PPM.