吸氧后^(99m)Tc-MIBISPECT显像对肺部肿瘤的鉴别诊断价值

Value of ^(99m)Tc-MIBI SPECT Imaging in Differential Diagnosis of Lung Tumors after Oxygen Inhalation

目的探讨吸氧后99m Tc-MIBI SPECT显像对肺部肿瘤的鉴别诊断价值.方法对32例CT发现肺部肿瘤患者进行前瞻性研究.所有受检者于注射99mTc-MIBI前10 min开始经面罩高流量吸氧,于注射后20 min、150 min分别进行早期和延迟SPECT断层显像.对显像结果进行定性及半定量分析,并根据最终病理诊断结果,判定该显像方法对肺部肿瘤的鉴别诊断价值.结果 20例肺部恶性肿瘤,12例肺部良性肿瘤,99m Tc-MIBI SPECT显像对肺部肿瘤良恶性鉴别诊断灵敏度90.0%、特异性75.0%、准确性84.3%.肺部恶性肿瘤早期摄取比值(EUR)为(2.94±1.98),95%CI:1.79%~3.43%.肺部良性肿瘤为(1.41±0.71),95%CI:1.19%~1.84%,两者差异有统计学意义(t=-2.43,P=0.037).肺部恶性肿瘤延迟摄取比值(DUR)为(2.97±1.91),95%CI:1.98%~3.53%,肺部良性肿瘤为(1.57±0.81),95%CI:1.18%~2.10%,两者差异有统计学意义(t=-2.48,P=0.016).半定量ROC分析显示:以早期摄取比值≥1.55为界值.对应灵敏度90.0%,特异性75.0%.以延迟摄取比值≥1.60为界值,灵敏度90.0%,特异性75.0%.结论吸氧后99m Tc-MIBI SPECT显像对肺部肿瘤的良恶性鉴别具有较高的临床应用价值.

Objective To explore the diagnostic value of ^99mTc-MIBI SPECT imaging in lung tumors after oxygen inhalation.Methods We performed a prospective study on 32 cases of CT found lung cancer patients. All patients received inhalation of high-flow oxygen via face mask 10 minutes before injection of ^99mTc-MIBI,and were given early and delayed SPECT scan 20 min and 150 min after injection. Imaging results were given qualitative and semi-quantitative analysis,and the diagnostic value of this imaging method for the identification of lung cancer was evaluated according to diagnostic value of this imaging method for the identification of lung cancer.Results There were 20 cases of lung cancer and 12 cases of pulmonary benign. The sensitivity of ^99mTc-MIBI SPECT imaging in the differential diagnosis of benign and malignant lung tumor was 90.0%,the specificity was 75.0%,the accuracy was84.3%.Lung cancer early uptake ratio（EUR） was 2.94±1.98（95% CI： 1.79%-3.43%）,benign lung tumor was 1.41±0.71（95% CI： 1.19%-1.84%）,the difference was statistically significant（t =-2.43,P = 0.037）.Lung cancer delayed uptake ratio（DUR） was 2.97 ± 1.91（95% CI： 1.98%-3.53%）,benign lung was 1.57±0.81（95% CI： 1.18,2.10）,the difference was statistically significant（t =-2.48,P = 0.016）. Semi-quantitative ROC analysis showed： the early uptake ratio ≥ 1.55 as the boundary value. Corresponding to 90.0% sensitivity,75.0% specificity.To delay the uptake ratio ≥ 1.60 cutoff value,sensitivity 90.0%,specificity of 75.0%.Conclusion ^99 m Tc-MIBI SPECT imaging has high clinical value in differential diagnosis of benign and malignant lung tumors after oxygen inhalation.