^(99m)Tc-甲氧基异丁基异腈显像对乳腺肿物及腋淋巴结转移的诊断

^(99m)Tc-methoxyisobutyl isonitrile imaging in identification of benign and malignant breast lesions and detection of metastatic axillary lymph node

目的 :研究 99m Tc-甲氧基异丁基异腈 (99m Tc- MIBI)显像鉴别诊断乳腺肿物的良、恶性及探测腋淋巴结转移的情况。方法 :对 5 1例可触及的乳腺肿物及 11例乳腺癌术后疑腋淋巴结转移患者分别于注射 99m Tc- MIBI后 10和 6 0 m in行平面显像 ,半定量分析肿物部位的摄取比值 (uptake ratio,U R) ,均与病理结果对比。 结果 :99m Tc- MIBI平面显像对可触及的乳腺肿物诊断乳腺癌的敏感性为 93.3% ,特异性为 95 .2 % ;阳性预测值为 96 .6 % ,阴性预测值为 90 .9%。探测腋淋巴结转移的敏感性为 6 4.0 % ,特异性为 94.1% ;阳性预测值为 94.1% ,阴性预测值为 6 4.0 %。结论 :99m Tc- MIBI平面显像鉴别乳腺肿物的良、恶性及探测腋淋巴结转移有较高的敏感性和特异性。

Objective: To identify benign and malignant breast lesions and detect metastatic axillary lymph nodes using 99m Tc methoxyisobutyl isonitrile(MIBI) imaging. Methods: Fifty one women with a palpable breast lesions and 11 patients suspicious of metastatic lymph node after primary breast cancer operation were studied with planar imaging 10 min and 60 min after injection of 99m Tc MIBI. Semiquantitative analysis of uptake ratio(UR) of 99m Tc MIBI in locations of tumour and lymph nodes were performed. All the results were compared with pathologic study. Results: In palpable lesions, the sensitivity of 99m Tc MIBI planar imaging for detecting primary breast cancer was 93.3% and the specificity was 95.2%;The positive predictive value was 96.6%. The negative predictive value was 90.9%. The sensitivity of 99m Tc MIBI planar imaging to detect metastatic axillary lymph nodes was 64.0% and the specificity was 94.1%;The positive predictive value was 94.1%. The negative predictive value was 64.0%. Conclusion: 99m Tc MIBI planar imaging has high sensitivity and specificity for differentiation of breast tumors and detection of axillary lymph node involvement. [