单光子发射型计算机断层成像在腮腺肿块诊断中的应用评价  

Evaluation of clinical value of technetium 99m(Ⅴ)dimercaptosuccinic acid SPECT in diagnosis of parotid lump

作　　者：伍晓山[1] 林国础[2] 张庆华[2] 

机构地区：[1]福建医科大学附属第一医院口腔外科,350000 [2]上海第二医科大学口腔医学院,200011

出　　处：《中华口腔医学杂志》1999年第6期334-336,共3页Chinese Journal of Stomatology

摘　　要：目的　探讨单光子发射型计算机断层成像 (singlephotonemissioncomputedtomography,SPECT)对腮腺肿块术前定性诊断的价值。方法　对 4 5例腮腺肿块患者术前 1～ 2周行腮腺区SPECT检查 ,以 5价99锝标记的二巯基丁二酸钠 [technetium 99m(V)dimercaptosuccinicacid ,99mTc(V)DMSA]为显像剂 ,结果与病理诊断、临床检查及灰阶超声结果相比较。结果　99mTc(Ⅴ ) DMSA SPECT对腮腺区恶性肿瘤诊断的敏感性、特异性、准确性分别为 93 7%、72 4 %、80 0 %。计算腮腺区肿块摄取比值发现 ,恶性肿瘤摄取比值高于良性肿瘤、囊肿、炎性肿块 ,它们之间统计学差异显著。结论　99mTc(Ⅴ ) DMSA SPECT可作为腮腺区肿块术前定性诊断的有效辅助手段 ,计算病灶区摄取比值有助于提高诊断的准确性 ,结合临床检查和超声诊断可减少SPECT诊断的假阳性。Objective To evaluate the clinical value of single photon emission computed tomography (SPECT) on classifying parotid lump as benign or malignant before treatment Methods SPECT images of the parotid region were obtained in forty five patients with parotid lump before surgery We used technetium 99m(Ⅴ) dimercaptosuccinic acid as imaging agent The results were compared with their pathological diagnoses,clinical examination,and ultrasonography Results The sensitivity, specificity and accuracy of Tc 99m(Ⅴ) DMSA SPECT imaging in determining malignancy of parotid lump were 93 7%,72 4%,80 0%, respectively The uptake ratios of parotid lesions were higher in malignant tumors than benign tumors, cysts,and inflammatory lumps ( P <0 05) Conclusion It is suggested that Tc 99m(Ⅴ) DMSA SPECT can be a useful aided method of preoperative diagnosis of parotid lumps The uptake ratios can help increase the accuracy of diagnoses For the benign tumors and inflammatory masses of parotid gland,the diagnoses had some false positives which may be reduced by combined clinical examination and ultrasonography

关 键 词：腮腺肿瘤 放射性同位素 CT 诊断 

分 类 号：R739.804[医药卫生—肿瘤]