^(99)Tc^m-MIBI与^(99)Tc^m-MDP骨显像诊断骨良恶性病变的比较

A comparison of two imaging agents, ^(99)Tc^m-MIBI and^(99)Tc^m-MDP, in differentiative diagnosis of malignant and benign bone lesions

目的 对比分析99Tcm 甲氧基异丁基异腈 (MIBI)和99Tcm 亚甲基二膦酸盐 (MDP)对骨良恶性病变的诊断价值和疗效评估。方法 6 1例临床拟诊骨良恶性病变患者分别进行 2项骨显像 ,其中 6例恶性肿瘤患者分别进行化疗前后显像。显像后均经手术、病理检查对比分析。结果 99Tcm MIBI显像 :73 %恶性肿瘤病灶肉眼见中、高度MIBI浓聚 ,6 0 %良性病灶肉眼未见MIBI聚集。恶性病灶部位与对侧正常组织放射性计数比值 (L C)即99Tcm MIBI摄取比值 (3 0 8± 1 6 7)明显高于良性病灶(1 36± 0 6 4) ,P <0 0 1。99Tcm MDP显像 :大多数恶性或良性病灶肉眼见中、高度MDP浓聚 ,但恶性病灶99Tcm MDPL C(3 76± 1 37)与良性病灶L C(3 10± 1 0 5 )比较差异无显著性 (P >0 0 5 )。化疗可以抑制99Tcm MIBI摄取 ,99Tcm MIBI摄取程度与99Tcm MDP比较能较好反应治疗效果。结论 99Tcm MIBI对鉴别诊断良恶性骨病和评估疗效有较好的应用价值 ,与99Tcm

Objective To compare the use of 99 Tc m MIBI and 99 Tc m MDP in differentiative diagnosis of malignant and benign bone lesions and in the assessment of tumor response to chemotherapy Methods 61 patients with various bone pathologies (41 malignant and 20 benign lesions) were studied with both imaging agents Planar 99 Tc m MIBI scintigraphy was performed 30 min after injection of 740 MBq of 99 Tc m MIBI Within 3 days after 99 Tc m MIBI study, the planar local and whole body bone scan were done 30 min and 3 h after injection of 740 MBq of 99 Tc m MDP, respectively Results With 99 Tc m MIBI imaging, most malignant focuses (73%) clearly showed medium high radioactivity accumulation Most benign focuses (60%) had not obviously visible uptake of 99 Tc m MIBI In quantitative analysis, the mean lesion/contralateral (L/C) ratio of malignant lesions (3 08±1 67) was significantly higher than that of benign counterparts (1 36±0 64, P<0 01) About 99 Tc m MDP bone scan: Most malignant or benign lesions showed visible medium high uptake of 99 Tc m MDP, but L/C (3 76±1 37) of malignant focuses versus that of benign focuses (3 10±1 05) was of no significantly difference (P>0 05) 6 cases with malignant tumor underwent both pre and post therapy 99 Tc m MIBI and 99 Tc m MDP evaluation, respectively It was demonstrated that chemotherapy was able to inhibit MIBI uptake Conclusions 99 Tc m MIBI imaging gave a good reflection of the effectiveness of therapy Combined application of two imaging agents was able to provide best clinical value in differentiative diagnosis and in evaluation of the therapy of malignant and benign bone lesions