^(99m)Tc-MIBI显像鉴别乳腺肿物良、恶性及探测腋窝淋巴结转移

^(99m)Tc-MIBI mammoscintigraphy in differentiation of nodular lesions of breast and detection of axillary lymph node metastasis from breast cancer

目的 :探讨99mTc 甲氧基异丁基异腈 (MIBI)肿瘤阳性显像方法对鉴别诊断乳腺肿物良、恶性及探测乳腺癌腋窝淋巴结转移的临床价值。方法 :对 60例一侧乳腺单发可触及肿物的女性患者 ,进行仰卧前位及俯卧左、右侧位99mTc MIBI肿瘤阳性显像。在 10～ 2 0min早期相和 90～ 12 0min延迟相中 ,观察双侧乳腺及双侧腋窝和锁骨上淋巴结区的放射性分布情况 ,并计算患乳病变区与相对应健侧的计数比值 (T/NT)。所有病例均有病理结果对照。结果 :99mTc MIBI肿瘤阳性显像鉴别诊断乳腺良、恶性病变的灵敏度为 92 .9% ,特异性为 90 .6% ,阳性预测值为 89.7% ,阴性预测值为 93 .5 % ,准确性为 91.7% ;诊断腋窝淋巴结转移的灵敏度为 83 .3 % ,特异性为 86.1% ,阳性预测值为 80 % ,阴性预测值为 88.6% ,准确性为 85 %。结论 :99mTc MIBI肿瘤阳性显像对于鉴别乳腺肿物的性质和探测腋窝淋巴结转移具有较高的诊断准确性 。

objective:To evaluate the clinical value of 99m Tc MIBI mammoscintigraphy in differentiation of nodular lesions of breast and detection of axillary lymph node metastases from breast cancer.Methods: 99m Tc MIBI breast imaging was performed in 60 patients with unilateral palpable breast masses.The early and delay images were acquired at 10～20 min and 90～120 min after injection of the tracer.The acquisition included three positions:anterior supine,left and right lateral prone.The ratio of T/NT was calculated as radioactivity of mass to that of oppositive corresponding tissue.The results were compared to pathological findings in all subjects.Results:With 99m Tc MIBI mammoscintigraphy to differentiate nodular lesion of breast,the diagnostic sensitivity and specificity were 92.9% and 90.6% respectively,positive and negative predictive value were 89.7% and 93.5% respectively,and the accuracy was 91.7%.And the sensitivity,specificity,positive predictive value,negative predictive value and accuracy of 99m Tc MIBI mammoscintigraphy for axillary lymph node metastases were 83.3%,86.1%,80%,88.6% and 85% respectively.Conclusion:It is suggested that 99m Tc MIBI mammoscintigraphy may be valuable in differentiating nodular lesions of breast and detecting axillary lymph node metastasis from breast cancer.