核素肾动态显像在肾脏占位病变性质评估中的价值  

Evaluation of ^99Tc^m-DTPA nuclear dynamic imaging in renal occupied disease

作　　者：陆国秀[1] 张彩霞[1] 徐薇娜[1] 于树鹏[1] 辛军[1] 

机构地区：[1]中国医科大学附属盛京医院放射科,沈阳110004

出　　处：《肿瘤研究与临床》2012年第1期41-45,共5页Cancer Research and Clinic

摘　　要：目的探讨核素肾动态显像（^99Tc^m-DTPA）对肾脏占位病变性质评估的价值。方法164例肾占位病例，术后均经病理证实，其中肾占位恶性病例119例，肾占位良『生病例45例，分析应用^99Tc^m-DTPA、超声检查（US）、计算机辅助体层摄影术（CT）、磁共振成像（MRI）、静脉肾盂造影（IVP）及正电子发射型计算机断层扫描显像（PET-CT）等影像技术鉴别肾占位病变性质的特点。结果几种常用影像学检查寇l生判断肾良、恶性占位病变的准确率如下：^99Tc^m-DTPA为84％、45％；US为72％、64％；CT为91％、92％；MRI为50％、67％；IVP为50％、17％；PET-CT诊断恶性占位准确率为67％。^99Tc^m-DTPA判断不同病理分期肾透明细胞癌阳性率差异具有统计学意义（X。83．4，P〈0．01）；判断肾内良性病变中肾囊肿与肾血管平滑肌瘤的阳性率分别为85％（22／26）和80％（12／15），差异无统计学意义（xz=0．0035，P〉0．05）。对直径〉4cm的病灶诊断符合率为68％（71／105），明显高于≤4cm者的33％（20／59），差异具有统计学意义（X。16．05，P〈0．05）。结论^99Tc^m-DTPA不仅能够定量评价肾脏功能，而且对判定肾占位病变的良恶性具有重要价值。Objective To evaluate ^99Tc^m-DTPA nuclear dynamic imaging in distinguishing the renal occupied disease. Methods A total of 164 in-patients with renal occupied disease who underwent surgery were included. According to the pathological diagnosis, 119 patients had malignant tumors, and 45 patients had benign diseases. All patients＂ imaging was retrospectively analyzed. Application of ^99Tc^m-DTPA nuclear dynamic imaging in renal occupied disease was compared with ultrasonography （US）, computed tomography （CT）, magnetic resonance imaging （MRI）, intravenous pyelogram （IVP）, and positron emission tomography （PET）-CT. Results The accuracy rates of different imaging methods in distinguishing between renal malignant and benign disease were ^99Tc^m-DTPA （84 %, 45 %）, US （72 %, 64 %）, CT （ 91%, 92 %）, MRI （50 %, 67 %）, WP （50 %, 17 %）, respectively. The diagnostic accuracy rate of PET-CT for malignant tumors was 67 %. The accuracy rates of ^99Tc^m-DTPA in distinguishing different phases of renal cell carcinoma were statistically significant （X^ 2 = 83.4, P 〈 0.01）, while the accuracy rates in distinguishing renal cyst from renal angiomyolipoma were not statistically different. With the greater diameter, the diagnostic accordance rate is higher （X ^2 = 16.05, P 〈 0.05）. Conclusion ^99Tc^m-DTPA could be used not only to evaluate the renal function uuantificationallv, but also be helnful to distinguish renal malianant tumor from benign disease.

关 键 词：肾肿瘤 囊肿 放射性核素显像 超声检查 体层摄影术 静脉造影术 血管 肌瘤 

分 类 号：R737.11[医药卫生—肿瘤]