局部注射^(99)Tc^m(V)-DMSA检测口腔癌颈淋巴结转移  

Scintigraphic detection of neck Iymph node metastases in patients with oral squamous cell carcinoma after local injection of ^(99)Tc^m(V)-dimercaptosuccinic acid

作　　者：张晔[1] 郭传瑸[1] 俞光岩[1] 赵光宇[2] 张春丽[2] 

机构地区：[1]北京大学口腔医学院口腔医院口腔颌面外科,100081 [2]北京大学第一医院核医学科

出　　处：《中华核医学杂志》2007年第4期230-231,共2页Chinese Journal of Nuclear Medicine

摘　　要：目的探讨局部注射正五价^(99)Tc^m 标记的二巯基丁二酸[^(99)Tc^m(V)-DMSA]检测口腔癌颈部淋巴结转移灶的可行性,为制定合理的口腔癌颈淋巴清扫术式提供参考。方法原发口腔鳞状细胞癌患者30例,癌周分点注射^(99)Tc^m(V)-DMSA,行头颈部断层和平面显像,寻找异常放射性浓聚区域,以 ROI 技术分析,将结果和术后病理检查结果比较。结果局部注射^(99)Tc^m(V)-DMSA检测颈部淋巴结转移灶的灵敏度为84.6%(11/13),特异性为82.4%(14/17),准确性为83.3%(25/30)。结论癌周局部注射^(99)Tc^m(V)-DMSA 检测口腔癌颈淋巴结转移的灵敏度高,准确性好,操作简便。Objective The status of regional nodal involvement bears clinical significance in management of patients of oral squamous cell carcinoma（OSCC）. The aim of this study was to evaluate the feasibility of ^99Tc^m （ V ）-dimercaptosuccinic acid （ DMSA ） imaging after local injection in detecting neck lymph node metastases in OSCC. Methods ^99 Tc^m （ V ）-DMSA was injected around tumor in 30 patients with primary OSCC. SPECT and planar scintigraphy were performed at 2 h after injection. Any focal uptake in neck was defined as positive lymph node. The ROI over the positive uptake lesion was drawn and the average radioactivity value was in comparison to that on the contra lateral side calculated. The scintigraphic resuits were then compared with postoperative pathological findings. Results The sensitivity, specificity and accuracy of ^99Tc^m （V）-DMSA imaging in detecting metastatic lymph nodes were 84. 6% （11/13）, 82.4% （14/17） and 83.3% （25/30）, respectively. The focal uptake values were much higher than the contra lateral regions in the positive patients （ P =0. 0001 ）. Conclusion 99Tcm （ V ） -DMSA scintigraphy after local tracer injection may be feasible to detect regional metastatic lymph nodes in patients with OSCC.

关 键 词：口腔肿瘤 淋巴转移 颈 体层摄影术 发射型计算机 单光子 DMSA 

分 类 号：R739.8[医药卫生—肿瘤]