^(99)Tc^m-MIBI SPECT/CT联合D-二聚体鉴别诊断口腔颌面部病变良恶性

^(99)Tc^m-MIBI SPECT/CT combined with D-dimer measurement in differentially diagnosing benign and malignant lesions of oral and maxillofacial

目的探讨^(99)Tc^m-MIBl SPECT/CT显像联合血浆D-二聚体检测鉴别诊断口腔颌面部病变良恶性的价值。方法对57例经病理确诊的口腔颌面部肿块患者行^(99)Tc^m-MIBI SPECT/CT显像并测量血浆D-二聚体,以术后病理结果为金标准,计算并比较^(99)Tc^m-MIBI SPECT/CT显像与血浆D-二聚体两种方法单独及联合诊断口腔额面部恶性肿瘤的灵敏度(敏感度)、特异度及准确率。结果 ^(99)Tc^m-MIBI SPECT/CT显像和血浆D-二聚体检测单独及联合诊断口腔颌面部恶性肿瘤的灵敏度(敏感度)、特异度、准确率分别为72.73%(16/22)、82.86%(29/35)、78.95%(45/57),68.18%(15/22)、74.29%(26/35)、7lI 93%(41/57)及95.45%(21/22)、94.29%(33/35)、94.74%(54/57),联合诊断恶性肿瘤的敏感度和准确率高于^(99)Tc^m-MIBI SPECT/CT(P均<0.05),联合诊断敏感度、特异度和准确率均高于D-二聚体检测(P均<0.05)。结论 ^(99)Tc^m-MIBI SPECT/CT显像与血浆D-二聚体检测联合应用可提高二者单独应用鉴别口腔颌面部病变良恶性的效能,具有重要临床价值。

Objective To evaluate the value of 99Tcm-MIBI SPECT/CT imaging combined with plasma D-dimer （D-D） measurement in differentially diagnosing benign and malignant lesions of oral and maxillofacial. Methods Fifty-seven patients of maxillofacial masses confirmed by pathology underwent 99 Tcm-MIBI SPECT/CT imaging and plasma D-D measurement. The sensitivity, specificity and accuracy of 99 Tcm-MIBI SPECT/CT imaging, plasma D-D measurement and combination of the two methods in diagnosing malignant tumors of oral and maxillofacial were calculated with pathological results as gold standard. Results The sensitivity, specificity and accuracy in diagnosing malignant tumors of oral and maxillofacial was 72.73% （16/22）, 82.86% （29/35）, 78.95% （45/57） for 99Tcm-MIBI SPECT/CT, 68.18% （15/22）, 74.29% （26/ 35）, 71.93% （41/57） for plasma D-D measurement and 95.45% （21/22）, 94.29% （33/35）, 94.74% （54/57） for combination of the two methods. The sensitivity and accuracy of combination dignosis were higher than those of 99Tcm-MIBI SPECT/CT, and the sensitivity, specificity and accuracy of combination dignosis were higher than those of plasma D-D measurement （all P〈0.05）. Conclusion 99Tcm-MIBI SPECT/CT fusion imaging combined with plasma D-D measurement improves the ability of the single methods in differentially diagnosing benign and malignant lesions of oral and maxillofacial, with significant clinical value.