不同图像采集和处理对^67Ga显像质量及病灶探查的影响  

The impact of different imaging modalities of ^67 Ga scintigraphy on the image quality and the ability in detection of lesions

作　　者：刘秀芹[1] 李文婵[1] 张建飞[1] 姚稚明[1] 

机构地区：[1]卫生部北京医院核医学科,100730

出　　处：《中华核医学杂志》2009年第6期417-420,共4页Chinese Journal of Nuclear Medicine

摘　　要：目的分析平面显像、非衰减校正（NAC）断层显像和CT衰减校正（AC）断层显像等^67Ga显像图像采集和处理模式对图像质量和病灶判断的影响。方法用美国GE Millennium^TM VG 5型SPECT／CT仪对31例活动期肺结节病患者行^67Ga平面显像、胸部NAC断层显像；并对断层图像行CTAC。图像分析：双盲法阅片，判断平面图像、AC和NAC断层图像的图像质量及病灶数；测量病变与周围正常组织的放射性计数，并测量其比值。采用SPSS10．0软件，行配对t检验和，检验。结果图像质量按照平面显像、NAC、AC顺序依次提高（χ^2=25．880，P〈0．001）。以活动期结节病患者SPECT／CT示放射性增高的肺门、纵隔淋巴结为“病灶”，平面显像发现“病灶”70个，漏诊“病灶”8个；NAC、AC断层图像均发现“病灶”78个。NAC图像中“病灶”的放射性计数明显低于AC图像中“病灶”的放射性计数（15．240±8．865和67．241±35．049，t=-17．230，P〈0．001）。和NAC图像比较，AC图像“病灶”与肺的放射性比值增高（t=-7．520，P〈0．001），“病灶”与肝（t=3．298，P=0．001）及“病灶”与腰椎（t=7，032，P〈0．001）的比值降低。结论^67Ga平面显像因前后组织放射性分布叠加，可能导致漏诊。^67Ga NAC断层显像能够较为准确地确定病变淋巴结的三维位置，但图像计数率低、噪声较大。AC断层图像虽未能增加检出的病灶数，但能有效提高NAC计数率，改善图像质量。Objective ^67 Ga scintigraphy is an important method in detection of active sareoidosis. The aim of this research was to study the influence of planar and tomography, with and without CT attenuation correction （ AC and NAC） , on ^67 Ga images on the image quality and the ability in detection of lesions. Methods Thirty one patients （13 male, 18 female, age range： 33- 87 years） with sareoidosis underwent ^67 Ga planar and tomographic scans, AC and NAC. The imaging quality and the ability in detection of hyperradioactive lymph nodes in lung hilar and mediastinal （lesion） among the planar, AC and NAC images were compared. The paired t-test and χ^2-test were used for data analysis with SPSS 10.0 software. Results From planar, NAC to AC, the image quality was better and better in proper order （χ^2 = 25. 88, P 〈 0. 001 ）. The planar imaging showed seventy lesions, while both AC and NAC images showed seventy-eight lesions. The radioactivity of lesions on AC image was significantly higher than that in NAC image （67. 241 ± 35. 049 and 15. 240 ±8. 865, respectively, t = - 17. 230, P 〈 0. 001 ）. The radioactivity ratio of lesion to those organs （lung, liver, lumbar vetabra） of AC was significantly higher than those of NAC, t = -7. 520, 3.298, 7.032, P〈0.01, =0.01 and 〈0.01. Conclusions ^67Ga tomographic scintigraphy can improve the ability in detection of hyperradioactive lung hilar and mediastinal lymph nodes compared with planar image does. CT AC for ^67 Ga tomography can improve the tomographic imaging quality.

关 键 词：体层摄影术 发射型计算机 单光子 体层摄影术 X线计算机 图像处理 计算机辅助 镓放射性同位素 质量控制 

分 类 号：R686[医药卫生—骨科学]