放射性计数半定量法用于观察骨质代谢异常探讨

Value of semi-quantitative analysis by ROI technique in bone metabolism

目的:探讨核素骨显像放射性计数半定量法在早期发现骨代谢异常中的价值。方法:63例乳腺癌患者按化疗方案分为ET(表阿霉素、艾素)组和ECT(表阿霉素、环磷酰胺、艾素)组。在治疗前、化疗3疗程、6疗程后,分别进行骨显像和骨密度(BMD)值测量。利用感兴区技术获取骨显像的腰椎、股骨计数并和全身计数进行对比(LRC/WRC、FRC/WRC),以及半定量分析。分析结果和骨密度方法进行对比。结果:ET组治疗前、化疗3个疗程、6个疗程后患者腰椎、股骨BMD值未见明显差异(P均>0.05)。腰椎、股骨放射性计数比值结果有显著差异(P<0.05)。ECT组治疗前、3个疗程、6个疗程后患者腰椎、股骨BMD值、放射性计数比值都有明显差异(P<0.05)。结论:放射性计数半定量法在发现骨代谢异常方面要早于骨密度法。该方法对存在高风险因素患者可能引发的骨代谢异常的早期发现有临床应用价值,是骨密度法的有益补充。

Objective：To investigate the value of Semi-quantitative analysis by ROI technique in bone metabolism.Methods：Sixty-three consecutive patients with breast cancer under 50 years were recruited for the study.The cases were divided into two groups depend on received ET and ECT.Semi-quantitative analysis by ROI technique from bone scintigraphy before and after chemotherapy,the bone mineral density（BMD）from dual-energy X ray examination on lumbar and femur.The results were compared in patients with different chemotherapeutic medications.Results：No significant difference of BMD of lumbar and femur were observed in breast cancer patients before,after 3 and 6 courses of treatment chemotherapy in patients treated with ET（P0.05）.Significant differences of BMD of lumbar and femur were observed in patients treated with ECT（P0.05）.Significant differences of radioactivity counts of ROI of lumbar and femur（LRC/WRC,FRC/WRC） were observed in breast cancer patients before,after 3 and 6 courses of treatment chemotherapy in patients treated with ET and ECT（P0.05）.However,no significant difference of radioactivity counts of ROI of lumbar and femur were observed between patients after 3 and 6 courses of treatment chemotherapy in patients treated with ET（P0.05）.Conclusion：Bone Semi-quantitative analysis by ROI technique is earlier than BMD in evaluating the abnormality of bone metabolism,and is highly effective in early detecting chemotherapy-caused bone loss.It is a necessarily complementary to BMD.