目的比较硝酸甘油介入^(99)Tc^m-tetrofosmin SPECT 心肌血流灌注显像与^(18)F-FDG PET 心肌代谢显像评估心肌活力的价值。方法既往有心肌梗死史伴左心功能不全经冠状动脉造影确诊为冠心病的患者36例,行二日法静息和硝酸甘油介入^(99)Tc...目的比较硝酸甘油介入^(99)Tc^m-tetrofosmin SPECT 心肌血流灌注显像与^(18)F-FDG PET 心肌代谢显像评估心肌活力的价值。方法既往有心肌梗死史伴左心功能不全经冠状动脉造影确诊为冠心病的患者36例,行二日法静息和硝酸甘油介入^(99)Tc^m-tetrofosmin SPECT 显像,并在1周内再行^(18)F-FDG PET 心肌代谢显像及静息超声心动图检查。将左心室分成13个节段,分析超声心动图室壁运动,并分析相同节段^(99)Tc^m-tetrofosmin 与^(18)F-FDG 的相对摄取比值,以^(99)Tc^m-tetrofosmin 摄取比值55%,^(18)F-FDG 摄取比值50%为判断心肌活力有无的阈值。以 k 统计比较3种方法的一致性。结果超声心动图示131个节段呈无运动或反向运动。^(99)Tc^m-tetrofosmin 静息显像示其中78个节段(60%)心肌有活力,53个节段(40%)无活力。该53个节段中14个(26%)在硝酸甘油介入后可见再填充,余39个节段无改变。在^(18)F-FDG PET 显像中,硝酸甘油介入显像再填充节段的心肌放射性摄取明显增高。再填充节段与无填充节段比较,心肌 FDG 摄取分别为(76±15)%和(58±17)%,差异有统计学意义(P<0.01)。硝酸甘油介入显像中,92个心肌节段(70%)有活力,39个无活力。tetrofosmin静息显像评估心肌活力与 FDG PET 显像比较,k 值为0.35,而硝酸甘油介入^(99)Tc^m-tetrofosmin SPECT与^(18)F-FDG PET 显像结果比较,k 值为0.53。结论硝酸甘油介入^(99)Tc^m-tetrofosmin SPECT 显像可提高对心肌活力的检测能力,与^(18)F-FDG PET 心肌代谢显像有很好的一致性。展开更多
In order to investigate the clinical significance of 99mTc-Tetrofosmin (TF) scintigraphy in the evaluation of lung cancer and mediastinal lymphoid node involvement, 33 patients with pulmo- nary neoplasmas were subje...In order to investigate the clinical significance of 99mTc-Tetrofosmin (TF) scintigraphy in the evaluation of lung cancer and mediastinal lymphoid node involvement, 33 patients with pulmo- nary neoplasmas were subjected to both 99mTc-TF scintigraphies and CT scans in one week before their operations or puncturations. All the images were judged visually and the emission images were analyzed with semi-quantitative methods in addition. The results of each group were compared. There was marked difference in target/non-target (T/N) ratio between the lung cancer group and the benign lesion group (P〈0.001). Moreover, in the lung cancer group, T/N ratio in tomographies was signifi- cantly higher than that in planar images (P〈0.01). The sensitivity and accuracy of semi-quantitative analysis in 99mTc-TF SPECT were significantly higher than those of CT in the diagnosis of pulmonary neoplasmas (P〈0.05 and P〈0.01 respectively), so was the sensitivity of 99mTc-TF SPECT vs CT in the diagnosis of mediastinal lymphoid node metastasis (P〈0.05). It was also found that epidermoid squamous cell carcinomas and adenocarcinomas had a higher T/N ratio than in small cell carcinomas (P〈0.05), and 2 h washout rate (WR) of adenocarcinomas was higher than that of epidermoid squamous cell carcinomas (P〈0.05). In conclusion, 99mTc-TF scintigraphy showed a favorable diag- nostic accuracy in appraising lung cancers and mediastinal lymph node metastases. Furthermore semi-quantitative technology can improve the accuracy, and is potential to offer some information about histological type of the cancer tissue. Therefore, 99mTc-TF scintigraphy will be a useful tool in the diagnosis and staging of lung cancer.展开更多
文摘目的比较硝酸甘油介入^(99)Tc^m-tetrofosmin SPECT 心肌血流灌注显像与^(18)F-FDG PET 心肌代谢显像评估心肌活力的价值。方法既往有心肌梗死史伴左心功能不全经冠状动脉造影确诊为冠心病的患者36例,行二日法静息和硝酸甘油介入^(99)Tc^m-tetrofosmin SPECT 显像,并在1周内再行^(18)F-FDG PET 心肌代谢显像及静息超声心动图检查。将左心室分成13个节段,分析超声心动图室壁运动,并分析相同节段^(99)Tc^m-tetrofosmin 与^(18)F-FDG 的相对摄取比值,以^(99)Tc^m-tetrofosmin 摄取比值55%,^(18)F-FDG 摄取比值50%为判断心肌活力有无的阈值。以 k 统计比较3种方法的一致性。结果超声心动图示131个节段呈无运动或反向运动。^(99)Tc^m-tetrofosmin 静息显像示其中78个节段(60%)心肌有活力,53个节段(40%)无活力。该53个节段中14个(26%)在硝酸甘油介入后可见再填充,余39个节段无改变。在^(18)F-FDG PET 显像中,硝酸甘油介入显像再填充节段的心肌放射性摄取明显增高。再填充节段与无填充节段比较,心肌 FDG 摄取分别为(76±15)%和(58±17)%,差异有统计学意义(P<0.01)。硝酸甘油介入显像中,92个心肌节段(70%)有活力,39个无活力。tetrofosmin静息显像评估心肌活力与 FDG PET 显像比较,k 值为0.35,而硝酸甘油介入^(99)Tc^m-tetrofosmin SPECT与^(18)F-FDG PET 显像结果比较,k 值为0.53。结论硝酸甘油介入^(99)Tc^m-tetrofosmin SPECT 显像可提高对心肌活力的检测能力,与^(18)F-FDG PET 心肌代谢显像有很好的一致性。
文摘In order to investigate the clinical significance of 99mTc-Tetrofosmin (TF) scintigraphy in the evaluation of lung cancer and mediastinal lymphoid node involvement, 33 patients with pulmo- nary neoplasmas were subjected to both 99mTc-TF scintigraphies and CT scans in one week before their operations or puncturations. All the images were judged visually and the emission images were analyzed with semi-quantitative methods in addition. The results of each group were compared. There was marked difference in target/non-target (T/N) ratio between the lung cancer group and the benign lesion group (P〈0.001). Moreover, in the lung cancer group, T/N ratio in tomographies was signifi- cantly higher than that in planar images (P〈0.01). The sensitivity and accuracy of semi-quantitative analysis in 99mTc-TF SPECT were significantly higher than those of CT in the diagnosis of pulmonary neoplasmas (P〈0.05 and P〈0.01 respectively), so was the sensitivity of 99mTc-TF SPECT vs CT in the diagnosis of mediastinal lymphoid node metastasis (P〈0.05). It was also found that epidermoid squamous cell carcinomas and adenocarcinomas had a higher T/N ratio than in small cell carcinomas (P〈0.05), and 2 h washout rate (WR) of adenocarcinomas was higher than that of epidermoid squamous cell carcinomas (P〈0.05). In conclusion, 99mTc-TF scintigraphy showed a favorable diag- nostic accuracy in appraising lung cancers and mediastinal lymph node metastases. Furthermore semi-quantitative technology can improve the accuracy, and is potential to offer some information about histological type of the cancer tissue. Therefore, 99mTc-TF scintigraphy will be a useful tool in the diagnosis and staging of lung cancer.