^(99m)Tc-MIBI与^(201)T1肺肿瘤阳性显像在原发性肺癌的比较

The Comparisom of Technetium 99m MIBI and Thallium 201 Lung Scintigraphy in Primary Lung Cancer

:【目的】评价99mTcMIBI与201T1肺肿瘤显像在原发性肺癌诊断中临床意义。【方法】28例肺癌患者进行了201T1早期(15min)与延迟(3h)肺肿瘤平面显像,其中23例有同期的99mTcMIBI显像资料;勾画各时相前位图像上病变部位(T)及对侧正常肺组织(N)的感兴趣区,计算摄取比值(T/N)及滞留指数[RI=(延迟T/N-早期T/N)×100/早期T/N)],并取病灶部位放射性较正常肺组织摄取明显增高为阳性指标进行定性分析。【结果】99m TcMIBI早期与延迟显像肉眼定性分析诊断肺癌的阳性率分别为8696%和7826%,201T1显像两者阳性率均为8929%;99mTcMIBI早期与延迟显像T/N分别为126±019与124±019,201T1为143±021和159±032,99mTcMIBI与201T1比较早期T/N之间与延迟T/N之间均有明显差异(t值分别为5538与733,P值均<0001);同时201T1显像所计算的滞留指数(1083±1180)%明显大于99mTcMIBI肺显像(-144±662)%,差异有显著意义(t=4307,P<0001)。【结论】99m TcMIBI与201T1肺显像在原发性肺癌的诊断中具有较高的阳性预测值,但肿瘤部位的滞留指数后者明显增高,提示201T1肺显像更具优越性,对于两者在肺癌淋巴结转移灶探测中的临床价值。

Objective To evaluate the clinical significance of 99m Tc MIBI and 201 T1 lung scintigraphy in the diagnosis of primary lung cancer. Methods Lung early(15～30 min) and delayed (3 h) planar scintigraphy were performed in 28 patients with lung cancer using 201 T1 and 23 patients simultaneously using 99m Tc MIBI. Regions of interest were placed over the tumors (T) and contralateral normal lung tissue(N), and T/N ratio and retention index [RI=(dealyed T/N early T/N)×100/early T/N] were calculated . Radioactivity uptake in tumor site above the normal lung tissue was considered as positive in optesthesia qualitative analysis. Results The positive rate was 86 96% in the early and 78 26% delayed images for 99m Tc MIBI and 89 29% in both the early and delayed images for 201 T1. There was a significant difference (P<0 01) on the early T/N between 99m Tc MIBI (1 26±0 19) and 201 T1 (1 43±0 21). The delayed T/N was 1 24±0 19 for 99m Tc MIBI and 1 59±0 32 for 201 T1, and this difference was also significant (P<0 001). The delayed index was (-1 44±6 62)% for 99m Tc MIBI and (10 83±11 80)% for 201 T1 (paired samples t test, P<0 001). Conclusion 99m Tc MIBI and 201 T1 lung scintigraphy have good positive prognostication in primary lung cancer diagnosis, but the retention index of 99m Tc MIBI in the tumor areas are significantly lower compared with those of 201 T1. The results suggest 201 T1 is superior to 99m Tc MIBI. The clinical value of 99m Tc MIBI and 201 T1 scintigraphy in detecting lymph node metastasis in patients with lung cancer is to be further studied.