^(201)Tl显像在肢体软组织良恶性病变鉴别中的应用  

The application of ^(201)T1 single photon emission computed tomography (SPECT) to differentiate malignant extremity soft tissue tumors from benign lesions

作　　者：李远[1] 王涛[1] 赵海涛[1] 杨发军[1] 刘文生[1] 牛晓辉[1] 

机构地区：[1]北京积水潭医院骨肿瘤科,100035

出　　处：《中国骨肿瘤骨病》2009年第4期214-218,共5页Chinse Journal Of Bone Tumor And Bone Disease

摘　　要：目的探讨^(201)Tl显像在肢体软组织良恶性病变鉴别诊断中的临床价值。方法 2003年6月～2006年2月,对55例肢体软组织病变患者进行^(201)Tl显像检查。其中恶性肿瘤33例,良性病变22例,所有病例的诊断均经活检或手术后组织学证实。静脉注射^(201)Tl 111MBq后15min(早期)和3h(延迟期)分别显像,进行肉眼分析并计算早期摄取比值(EUR)、延迟期摄取比值(DUR)及滞留指数(RI)。对比恶性组和良性病变组早期摄取比值、延迟期摄取比值及滞留指数,并分别行t检验进行半定量分析。结果半定量分析33例恶性病变和22例良性病变的EUR分别为3.00±2.60和1.77±1.04,两者的差异有显著性意义(t=2.468,P<0.05);两者的DUR分别为2.13±1.40和1.39±0.06,差异有显著性意义(t=2.663,P<0.05)。两组间RI差异无显著性意义(t=0.661,P>0.5)。本研究判断肢体软组织恶性病变标准:(1)RI正值首先考虑恶性病变;(2)EUR>1.7且DUR>1.4首先考虑恶性病变;(3)脂肪来源肿瘤EUR>1.2提示为恶性肿瘤。以此标准判断本组肢体软组织病变良恶性,则敏感性为84.8%、特异性为77.3%、准确性为81.8%。结论 ^(201)Tl显像可作为肢体软组织良恶性病变鉴别诊断的影像学检查方法。Objective To investigate the clinical significance of ^201T1 SPECT in differentiating malignant extremity soft tissue tumors from benign lesions. Methods From June 2003 to February 2006, 55 patients with extremity soft tissue tumors underwent ^201T1 scintigraphy in our department. Among all patients, 33 sustained malignant soft tissue tumor, and 22 sustained benign lesions. All diagnosis were confirmed by biopsy or post-operative histological tests. ^201T1 scintigraphy was performed with an early image acquired at 15 minutes and a delayed image at 3 hours after intravenous injection of 111MBq of ^201T1. Qualitative analysis were done by visual interpretation. Simultaneously, the traditional method of early uptake ratio（EUR）, delay uptake ratio（DUR）and retention index（RI）were also calculated as semi-quantitative to help with the differential diagnosis of the extremity soft tissue tumors. The EUR, DUR and RI of malignant soft tissue tumors were compared with benign lesions. Results The EUR of 33 malignant and 22 benign lesions was 3.00 and 1.77 respectively. There was statistical significance of the difference between two groups （t=2.468, P〈0.05）. The DUR of 33 malignant and 22 benign lesions was 2.13 and 1.39 respectively. The difference of the DUR in the two groups was significant （t=2.663,P〈0.05）. However, no significant differences were observed in the RI between malignant tumors and benign lesions （t=0.661,P〉0.05）. The criteria to determine the malignancy of the tissue were summed up in this study. 1） If the RI is fositive, malignancy should be considered first. 2） If the EUR〉1.7, and DUR〉1.4, malignancy should be considered first. 3） If the EUR in adipose tissue-derived tumor is higher than 1.2, malignancy should be considered first. With these criteria, we found that the sensitivity was 84.8%, the specificity was 77.3% and the accuracy was 81.8%. Conclusions ^201T1 SPECT is one of the essential methods for diffrentiating malignant extremity soft tissue tumors from beni

关 键 词：铊放射性同位素 单光子发射型计算机成像 肢体软组织肿瘤 

分 类 号：R738.6[医药卫生—肿瘤]