^(99)Tc^m-M IBI放射性核素闪烁显像鉴别骨良恶性病变的临床评估  

99 Tc m MIBI scintigraphy in the differential diagnosis of benign and malignant bone lesions

作　　者：徐海峰[1] 周润锁[1] 刘瑶娟[1] 穆继珍[1] 曹新健 高峰[1] 杨健[1] 

机构地区：[1]第四军医大学唐都医院核医学科,陕西西安710038

出　　处：《第四军医大学学报》1999年第9期786-789,共4页Journal of the Fourth Military Medical University

摘　　要：目的：初步评价９９ Ｔｃｍ 甲氧异丁基异腈（ Ｍ Ｉ Ｂ Ｉ）闪烁显像对骨良恶性疾病的鉴别诊断的临床价值． 方法：对６１ 例临床拟诊的骨良恶性病变患者，分别给予静脉“弹丸”注射９９ Ｔｃｍ  Ｍ Ｉ Ｂ Ｉ７４０ Ｍ Ｂｑ，即刻行早期血流显像和３０ ｍ ｉｎ～６０ ｍ ｉｎ病灶局部平面扫描． 结果分析用肉眼判断和 Ｒ Ｏ Ｉ技术计算病变部位与对侧相应部位计数比值． 所有患者２ ｗ ｋ～４ ｗ ｋ 后行手术治疗，并做病理检查对比． 结果：肉眼分析发现，大部分恶性骨肿瘤病灶（７３％ ，３０／４１ 例）在动脉血流灌注相和３０ ｍ ｉｎ～６０ ｍ ｉｎ 平面相中显示了９９ Ｔｃｍ  Ｍ Ｉ Ｂ Ｉ中高度浓集． 小部分患者显示了轻度９９ Ｔｃｍ  Ｍ Ｉ Ｂ Ｉ聚集． 仅有３ 例和２ 例患者病灶组织分别在动脉血流相和 ３０ ｍ ｉｎ ～６０ ｍ ｉｎ 平面相时未明确显示９９ Ｔｃｍ  Ｍ Ｉ Ｂ Ｉ浓聚影． 大部分良性骨及软组织病灶（６０％ ，１２／２０ 例），在血流灌注相或３０ ｍ ｉｎ～ ６０ ｍ ｉｎ 平面像均未见９９ Ｔｃｍ  Ｍ Ｉ Ｂ Ｉ浓聚影，但有 ３０％ （６／２０ 例）显示中度放射性浓聚，１０％ （２／２０ 例）显示轻度放射性浓聚． 定量分析表明：在早期血流灌注相，恶?AIM: To evaluate the clinical value of 99 Tc m MIBI scintigraphy in differentiating the benign and malignant bone lesions. METHODS: Sixty one patients with various bone pathologies (41 malignant and 20 benign lesions) were studied. All the patients had radionuclide angiography with 740 MBq 99 Tc m MIBI, followed by planar imaging 30 60min later. RESULTS: In visual analysis, 73% (30/41) malignant bone tumor focuses showed medium high radioactivity accumulation of 99 Tc m MIBI and 19% (8/41) malignant focuses revealed light concentration of radioactivity. The 99 Tc m MIBI concentration was not visualized in only 3 malignant focuses. But more benign focuses (60%, 12/20) had no obvious uptake of 99 Tc m MIBI. Only 30% (6/20) benign focuses showed medium accumulation of radioactivity and only 2 benign focuses revealed light uptake of 99 Tc m MIBI. In quantitative analysis, the perfusion index (PI) derived from 99 Tc m MIBI radionuclide angiography on malignant and benign lesions was obtained respectively. The PI of malignity (3.02±1.67) and low malignity (4.47±1.46) versus benignity (1.22±0.44) was significantly different ( P <0.01) and 99 Tc m MIBI uptake rate (UR) on malignant lesions (2.80±1.64), low malignant lesions (4.40±1.10) versus benign lesions (1.36±0.64) was also remarkably different ( P <0.01). It was found that PI was well correlated with UR of 99 Tc m MIBI in malignant ( r =0.72) and benign focuses ( r =0.81). CONCLUSION: Technetium 99m MIBI scintigraphy is a promising method for the differential diagnosis and evaluation of benign and malignant bone lesions.

关 键 词：骨肿瘤 放射性核素显像 甲氧异丁基异 

分 类 号：R738.104[医药卫生—肿瘤] R730.44[医药卫生—临床医学]