^(99m)Tc-MDP骨三相扫描在骨肉瘤诊断中的临床价值  

The value of three-phase imaging of ^(99m)Tc-MDP in osteosarcoma

作　　者：王胜军[1] 汪静[1] 曾瑾[1] 王喜青[1] 王云雅[1] 梁晓燕[1] 

机构地区：[1]第四军医大学西京医院核医学科,陕西西安710032

出　　处：《现代肿瘤医学》2008年第6期1019-1021,共3页Journal of Modern Oncology

摘　　要：目的:探讨99mTc-MDP骨三相扫描在骨肉瘤病人中的显像特点和应用价值。方法:回顾了我院2006年4月-2007年1月经穿刺活检及手术病理诊断为骨肉瘤的24例患者,男12例,女12例,最小年龄11岁,最大50岁,平均年龄20.6岁,所有患者都使用GE公司的Hawkeye SPECT进行99mTc-MDP骨三相扫描,图像经Entegra工作站处理。在血流灌注相,利用感应区技术(ROI),就肿瘤血流灌注开始时间、最高计数率、计数率达高峰时间、快速灌注持续时间、计数率-时间曲线斜率、曲线下面积与健侧进行比较,行两样本均数比较t检验。并计算计数率-时间曲线斜率比值、曲线下面积比值。另外计算血池相计数与对侧比值、延迟相计数与对侧比值(T/NT)及两样本均数比较配对t检验。观察结果延迟相的显像特点。结果:58.3%发生在股骨的(14/24),其中股骨下9例;37.5%发生在胫骨(9/24),其中胫骨上7例;发生在腓骨仅1例;累及2块骨头以上为5例。未发现远处部位转移。肿瘤血流灌注平均开始时间、计数率达高峰时间、快速灌注持续时间、最高计数率、计数率-时间曲线斜率、曲线下面积分别为(3.04±1.94)s,(13.43±3.98)s,(10.52±3.06)s,(958.26±469.24)counts/s,99.15±61.02,(49797±25157.24)counts,健侧分别为(4.70±3.25)s,(18.26±5.69)s,(13.57±4.57)s,(270±160.51)counts/s,23.22±19.20,(13403±8821.95)counts,两者相比均有统计学意义(P(0.05),两者斜率比值为6.03±4.68,曲线下面积比值为4.99±3.62。血池相计数与对侧比值、延迟相计数与对侧比值分别为3.34±1.53,6.02±3.12,两者相比具有统计学意义(P(0.05)。延迟显像,放射性异常高度浓聚,核素分布均匀41.7%,不均匀者58.3%,病变内出现放射性稀疏、缺损者占54.2%,另外软组织可见侵犯并有不均匀放射性浓聚。结论:99mTc-MDP骨三相扫描为骨肉瘤的诊断提供了丰富的信息,具有较高的临床价值。Objective ：To study the character of three - phase imaging of ^99Tc-MDP in osteosarcoma. Methods ： Retrospective analysis of 24 patients who confirmed by pathology in our hospital from April ,2006 to January,2007. All the cases performed three - phase imaging of ^99Tc-MDP . To summarize the character of blood flow perfusion phase imaging of ^99Tc-MDP in osteosarcoma, compared with opposite side, including perfusion begin time , max count rate, time to peak count rate, persistence time of fast perfusion, slope rate of count rate - time curve, the area below the count rate - time curve, and two independent samples t test. Calculation the ratio of count rate, the slope rate of count rate - time curve and the area below the count rate - time curve between tumor and opposite side, in addition calculating the ratio of counts of blood pool phase between tumor and opposite side, the ratio of counts of delay phase between tumor and opposite side and two paired - samples t test. Furthermore review the character of tumor on delay phase imaging. Results：58.3% （14/24） tumors located in femoral bone, 9 cases among them in inferior of femoral bone. And 37.5 % （9/24） tumors located in tibia, 7 cases of them in superior of tibia. 1 case involved fibula and 5 cases involved more than 2 bones. No metastasis sites were found. The multiple parameters between tumor and opposite side, such as perfusion begin time , max count rate, time to peak count rate, persistence time of fast perfusion, slope rate of count rate - time curve, the area below the count rate - time curve, were （ 3.04 ± 1.94） s, （13.43 ±3.98）s,（10.52±3.06）s,（958.26 ±469.24） counts/s ,99. 15 ± 61.02, （49797 ± 25157.24） counts, and（4.70 ±3.25）s,（18.26 ±5.69） s,（13.57 ±4.57）s,（270 ± 160.51） counts/s,23.22 ± 19.20, （13403 ± 8821.95 ） counts,respectively, there were statistical significance （ P 〈 0.05 ）. The ratio of slope rate of count rate - time curve and the area below the count rate - time curve b

关 键 词：骨肉瘤 锝放射性同位素 核医学显像/三时相 

分 类 号：R738[医药卫生—肿瘤]