HawkeyeVG型SPECT／CT融合显像在下消化道出血定位中的临床应用

Clinical application of Hawkeye VG SPECT/CT imaging in the bleeding position of lower gastroin- testinal

目的利用^99Tc^m体内标记RBC法，探讨HawkeyeVG型SPECT／CT融合显像在下消化道出血定位诊断中的临床应用价值。方法回顾性分析56例确诊下消化道出血的患者资料，其中男42例，女14例，年龄10～76岁。采用体内标记法标记RBC，剖腹探查术前静脉注射^99Tc^mO4^-洗脱液370MBq后即刻行下腹部平面显像，随后在同一床位行SPECT和CT扫描，并进行图像融合处理。分析图像，进行下消化道出血的定位诊断。驴检验分析平面显像与SPECT／CT融合显像的诊断灵敏度与定位准确性间的差异。结果56例患者中，平面显像和融合显像示下腹部有放射性异常浓聚灶者分别为50例和52例。2种显像方法各有42例和52例完成出血定位诊断，其中平面显像有31例，融合显像有48例定位与手术探查出血点一致。2种显像方法诊断灵敏度分别为89．3％（50／56）和92．9％（52／56），差异无统计学意义（x^2=0．11，P〉0．05）；定位准确性分别为73．8％（31／42）和92．3％（48／52），两者差异有统计学意义（X^2=4．63，P〈0．05）。结论HawkeyeVG型SPECT／CT融合显像是一种灵敏、简便、准确的下消化道出血定位检查方法。

Objective To evaluate the clinical application of Hawkeye VG SPECT/CT imaging on diagnosing and locating lower gastrointestinal bleeding using in vivo labeling 99Tem-RBC. Methods Fifty- six patients （42 males, 14 females, age ranging from 10 to 76 years） who had definite lower gastrointestinal bleeding were studied retrospectively. All patients had intravenous injection with 370 MBq ^99Tc^m-RBC and then underwent planar, SPECT, and CT imaging respectively in the abdomen before exploratory laparotomy. Images from SPECT and CT were fused thereafter to locate the active bleeder, if any. X2 test was performed to show the differences of diagnostic sensitivity and accuracy between planar and SPECT/CT imaging. Re- sults In 56 patients with lower gastrointestinal bleeding, 50 patients showed abnormally concentrated radionu- elide activity with planar images and 52 patients showed the similar imaging pattern with SPECT/CT. Among these patients, concordant bleeding with operation findings was found in 31 patients with planar images and 48 patients with SPECT/CT images. The sensitivity and accuracy were 89.3% （50/56） and 73.8% （31/ 42） in planar images, and 92.9% （52/56） and 92.3% （48/52） in SPECT/CT images （X2 = 0.11, P〉 0. 05; X2 = 4.63, P〈0.05）. Conclusion Hawkeye VG SPECT/CT imaging shows an effective, simple and accurate method and could be used for diagnosing and locating lower gastrointestinal bleeding.