双时相^(99)Tc^m-MDP断层显像在乳腺疾患中的应用

Application of dual-phase tomographic imaging with 99Tcm-MDP in diagnosis of breast diseases

目的观察和分析双时相99Tcm-MDP断层显像对乳腺疾患的临床诊断价值。方法共有50名女性健康志愿者和68例乳腺肿块患者行双时相99Tcm-MDP乳腺断层显像。通过感兴趣区分别计算健康志愿者的双乳相对应部位和乳腺肿块患者早期及延迟期的健患两侧的局部放射性计数和T/NT比值,并与术后或活检病理结果进行对照分析。结果①乳腺肿块良性病变组早期和延迟期T/NT比值为2.15±0.40和1.10±0.30,两者间差异有统计学意义(P<0.05);乳腺癌组早期和延迟期T/NT比值为4.51±0.30和3.49±0.40,两者间无显著差异(P>0.05);正常乳腺组早期和延迟期T/NT比值为1.06±0.03和1.03±0.06。良性病变组、乳腺癌组与正常乳腺组比较早期T/NT比值有统计学差异(P<0.05);乳腺癌组与正常乳腺组和良性病变组间的延迟期T/NT比值有显著差异(P<0.05)。②双时相99Tcm-MDP乳腺断层显像诊断乳腺癌的灵敏度为91.7%,特异性为93.8%,准确性为92.7%,阳性预测值为94.3%,阴性预测值为90.9%。结论双时相99Tcm-MDP乳腺断层显像是一种具有较高诊断灵敏度和特异性的乳腺疾患检查方法,对乳腺良恶性病变的鉴别诊断具有一定的临床价值。

Objective To explore the clinical diagnostic value of dual-phase 99Tcm-MDP tomography for breast diseases. Methods Fifty female healthy volunteers and 68 female patients with breast diseases received double-phase 99Tcm-MDP tomography in this study.Radioactive counts and target/non-target（T/NT） ratio in ROI of two sides of breasts in healthy volunteers and patients with breast diseases were calculated in early phase and delayed phase respectively,and these results were compared with surgery or biopsy pathology. Results ①T/NT ratio in benign breast lesions was 2.15±0.40 and 1.10±0.30 in early and delayed phases respectively（P0.05）.T/NT ratio in breast cancers was 4.51±0.30 and 3.49±0.40 in early and delayed phases respectively（P0.05）.T/NT ratio in early phase was significantly different among normal controls,benign breast lesions and breast cancers（P0.05）.T/NT ratio in delayed phase had significant difference between breast cancers and normal controls or benign breast lesions（P0.05）.②The overall sensitivity and specificity of dual-phase 99Tcm-MDP tomography in diagnosis of breast cancers were 91.7% and 93.8% respectively,the accuracy was 92.7%,and the positive and negative predictive values were respectively 94.3% and 90.9%. Conclusion The dual-phase 99Tcm-MDP tomography is a more sensitive and specific imaging method in the diagnosis of breast diseases,and plays a role in the differential diagnosis of benign breast lesions and breast cancers.