^(99m)Tc-甲氧基异丁基异腈显像诊断乳房肿块的临床价值

The value of ^(99m)Tc-MIBI SPECT in the diagnosis of breast mass

目的 评价99mTc 甲氧基异丁基异腈 (MIBI)显像鉴别乳房肿块良恶性的价值。方法 对 10 6例乳房肿块行99mTc MIBI显像检查 ,全部病例均经手术治疗 ,与病理结果比较。结果 10 6例中乳腺癌 5 6例 ,显像阳性 48例 ,假阴性主要为肿块较小的乳腺癌 ;良性病变 5 0例 ,显像阴性 40例 ,假阳性主要为血供丰富的大纤维腺瘤。该法诊断乳腺癌的灵敏度为 85 7%、特异性为 80 0 %、阳性预告值 82 8%、阴性预告值 83 3 %、总正确诊断率为 83 0 %。结论 99mTc MIBI显像是鉴别乳房良恶性肿块的有效的、无创性检查方法 ,但对大纤维腺瘤和较小的恶性肿块诊断作用较差。

Objective [WT5”BZ] To evaluate 99m Tc MIBI SPECT in differentiating malignancies from benign breast masses.[WT5”HZ]Methods [WT5”BZ] 106 patients with palpable breast masses underwent the examination of 99m Tc MIBI SPECT Tentative diagnosis was evaluated by postoperative pathology in all cases.[WT5”HZ]Results [WT5”BZ] 48 of the 56 cases of breast carcinoma were preoperatively diagnosed by 99m Tc MIBI SPECT, 40 of the 50 patients with benign lesions were scintimammographically negative The sensitivity of the examination was 85 7%, specificity was 80 0%, positive predictive value was 82 8%, negative predictive value was 83 3%, and the diagnostic accuracy was 83 0%. False positive results were found mainly in large fibroadenomas with abundant vascularities and false negative results were mainly from some small malignant tumors.[WT5”HZ]Conclusions [WT5”BZ] 99m Tc MIBI SPECT is an effective, noninvasive diagnostic method for primary breast cancer. But its value is limited in detecting large fibroadenoma and small malignancy. [WT5”HZ]