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
目的通过分析肺动脉缺如患者的误诊过程,分析肺通气/灌注显像等肺栓塞确诊手段的特点。方法对我院收治的1例误诊为肺栓塞的右上肺动脉缺如病例资料进行回顾性分析,并针对指南推荐的肺栓塞确诊手段复习相关文献。结果本例为中年男性,以...目的通过分析肺动脉缺如患者的误诊过程,分析肺通气/灌注显像等肺栓塞确诊手段的特点。方法对我院收治的1例误诊为肺栓塞的右上肺动脉缺如病例资料进行回顾性分析,并针对指南推荐的肺栓塞确诊手段复习相关文献。结果本例为中年男性,以喘憋伴双下肢水肿3周余入院,经相关医技检查诊断为慢性阻塞性肺疾病、慢性肺源性心脏病、右心衰、肺动脉高压、重度阻塞性睡眠呼吸暂停低通气综合征,经肺通气/灌注显像提示双肺多发栓塞(累及5个肺段),补充诊断为肺栓塞,予华法林口服抗凝及对症支持治疗后病情缓解出院。13 d后因咳嗽、咯血再次入院,急查国际标准化比率2.20,停用华法林后观察仍有咯血。行肺动脉、主动脉及支气管动脉造影示:右上肺动脉近段纤细、以远缺如,左下肺动脉纤细,平均肺动脉压35 mm Hg,右下肺支气管动脉迂曲、扩张。修正诊断为右上肺动脉缺如,于病变支气管动脉近端行弹簧圈栓塞术,术后咯血停止。结论肺动脉缺如很难第一时间确诊,多因反复咳嗽、咯血、憋气就诊,常误诊为肺栓塞或支气管扩张等其他呼吸系统疾病,肺动脉造影是诊断该病的"金标准"。肺通气/灌注显像作为肺栓塞的排除性诊断手段对诊断肺动脉缺如价值有限,肺栓塞的诊断应基于医技检查前评估临床诊断的可能性,对高度可能者选择确诊手段,对低度可能者选择排除性诊断检查,最大限度避免肺栓塞的诊断不足和诊断过度。展开更多
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.
文摘目的通过分析肺动脉缺如患者的误诊过程,分析肺通气/灌注显像等肺栓塞确诊手段的特点。方法对我院收治的1例误诊为肺栓塞的右上肺动脉缺如病例资料进行回顾性分析,并针对指南推荐的肺栓塞确诊手段复习相关文献。结果本例为中年男性,以喘憋伴双下肢水肿3周余入院,经相关医技检查诊断为慢性阻塞性肺疾病、慢性肺源性心脏病、右心衰、肺动脉高压、重度阻塞性睡眠呼吸暂停低通气综合征,经肺通气/灌注显像提示双肺多发栓塞(累及5个肺段),补充诊断为肺栓塞,予华法林口服抗凝及对症支持治疗后病情缓解出院。13 d后因咳嗽、咯血再次入院,急查国际标准化比率2.20,停用华法林后观察仍有咯血。行肺动脉、主动脉及支气管动脉造影示:右上肺动脉近段纤细、以远缺如,左下肺动脉纤细,平均肺动脉压35 mm Hg,右下肺支气管动脉迂曲、扩张。修正诊断为右上肺动脉缺如,于病变支气管动脉近端行弹簧圈栓塞术,术后咯血停止。结论肺动脉缺如很难第一时间确诊,多因反复咳嗽、咯血、憋气就诊,常误诊为肺栓塞或支气管扩张等其他呼吸系统疾病,肺动脉造影是诊断该病的"金标准"。肺通气/灌注显像作为肺栓塞的排除性诊断手段对诊断肺动脉缺如价值有限,肺栓塞的诊断应基于医技检查前评估临床诊断的可能性,对高度可能者选择确诊手段,对低度可能者选择排除性诊断检查,最大限度避免肺栓塞的诊断不足和诊断过度。
