氧介入^(99m)Tc-MIBI SPECT/CT同机融合鉴别诊断孤立性肺结节  

^(99m)Tc-MIBI SPECT/CT fusion imaging combined with oxygen intervention for differential diagnosis of solitary pulmonary nodules

作　　者：董燕玉[1] 刘长江[2] 张立广[3] 王凯华[1] 曾群雁[2] 李斌[4] 

机构地区：[1]承德医学院附属医院体检中心,河北承德067000 [2]承德医学院附属医院核医学科,河北承德067000 [3]承德医学院附属医院肿瘤内科,河北承德067000 [4]承德医学院附属医院小儿内科,河北承德067000

出　　处：《中国医学影像技术》2012年第3期503-506,共4页Chinese Journal of Medical Imaging Technology

基　　金：河北省卫生厅重点科技研究计划(20090585);承德市科技支撑计划项目(200922065)

摘　　要：目的探讨氧介入99mTc-MIBI SPECT/CT同机融合鉴别诊断孤立性肺结节(SPN)的价值。方法收集34例SPN患者,令其于注射99mTc-MIBI前吸氧。分别于注射99mTc-MIBI后10min、2h进行早期和延迟SPECT/CT断层同机融合显像,分析良、恶性SPN早期摄取比值(EUR)和延迟摄取比值(DUR),并对其诊断效率进行ROC曲线分析。结果 34例SPN患者中,10例为原发性肺癌;24例良性肺部病变。氧介入99mTc-MIBI SPECT/CT同机融合显像定性分析鉴别诊断良、恶性SPN的敏感度为90.00%(9/10),特异度为87.50%(21/24),准确率为88.24%(30/34),阳性预测值为75.00%(9/12),阴性预测值为95.45%(21/22)。恶性SPN的EUR为2.13±0.62(95%CI 1.68～2.57),良性SPN为1.31±0.42(95%CI 1.13～1.48);恶性SPN的DUR为2.40±0.47(95%CI 2.07～2.74),良性SPN为1.37±0.64(95%CI 1.09～1.64)。恶性肺部病灶EUR和DUR均显著高于良性肺部病灶(t=4.53、4.59,P均<0.001)。半定量ROC分析显示,以EUR≥1.50为界值,敏感度90.00%,特异度79.20%;以DUR≥1.47为界值,敏感度100%,特异度79.20%。结论氧介入99mTc-MIBI SPECT/CT同机融合显像对鉴别良、恶性SPN具有较高的临床价值。Objective To explore the differential diagnostic value of 99mTc-MIBI SPECT/CT fusion imaging combined with oxygen intervention for solitary pulmonary nodule（SPN）.Methods Thirty-four patients with SPN were enrolled.All patients absorbed oxygen before 99mTc-MIBI injection.The early and delayed SPECT/CT fusion imaging of the chest were performed 10 min and 2 h after 99mTc-MIBI injection,respectively.The early and delayed uptake ratios（EUR and DUR） of benign and malignant SPN were compared.The efficiency of EUR and DUR in diagnosing SPN were analyzed with ROC curve.Results There were 10 patients with malignant SPN and 24 patients with benign SPN.The sensitivity,specificity,accuracy rate,positive predictive value and negative predictive value of qualitative analysis was 90.00%（9/10）,87.50%（21/24）,88.24%（30/34）,75.00%（9/12） and 95.45%（21/22）,respectively.In patients with malignant SPN,EUR was 2.13±0.62（95%CI 1.68—2.57）,whereas that in patients with benign SPN was 1.31±0.42（95%CI 1.13—1.48）.In patients with malignant SPN,DUR was 2.40±0.47（95%CI 2.07—2.74）,whereas that in patients with benign SPN was 1.37±0.64（95%CI 1.09—1.64）.EUR and DUR were significantly different between malignant and benign SPN（t=4.53,4.59;both P0.001）.Semiquantitative analysis showed that when EUR≥1.50,the value of sensitivity and specificity was 90.00% and 79.20%,for DUR ≥1.47,the value of sensitivity and specificity was 100% and 79.20%,respectively.Conclusion 99mTc-MIBI SPECT/CT fusion imaging combined with oxygen intervention has good clinical value in differential diagnosis of malignant and benign SPN.

关 键 词：99M锝甲氧基异丁基异腈 体层摄影术 发射型计算机 单光子 体层摄影术 X线计算机 孤立性肺结节 肺肿瘤 

分 类 号：R563[医药卫生—呼吸系统] R817.4[医药卫生—内科学]