乳腺肿块^(99m) Tc-MIBI双时相显像与X线钼靶对照研究  

Comparison with Double - phase ^(99m)Tc - MIBI Scintimammography and Mammography in Diagnosis of Breast Lesions

作　　者：朱汇庆[1] 林祥通[1] 刘永昌[1] 徐莲琴[1] 龚海霞 

机构地区：[1]上海医科大学附属华山医院放射科,200040

出　　处：《中国医学计算机成像杂志》2000年第3期202-204,共3页Chinese Computed Medical Imaging

摘　　要：目的：探讨^(９９ｍ)ＴＣ－ＭＩＢＩ双时相乳腺显像和乳腺钼靶的联合应用对提高患者术前诊断准确性的价值。材料和方法：对疑为乳腺癌的 ３４名患者术前行钼靶检查和^(９９ｍ)Ｔｃ－ ＭＩＢＩ双时相乳腺显像。乳腺钼靶：双乳分别行轴位（头足位）和侧位摄片。乳腺双时相核素显像采用平面显像行正位、双侧斜位、俯卧位时双侧乳腺侧位。所有病例均于两项检查后两星期内行手术获得病理诊断。结果：^(９９ｍ)Ｔｃ－ ＭＩＢＩ乳腺双时相显像示：乳腺的早期和延迟显像一致。恶性病变早期和延迟相的平均Ｔ／Ｎ值分别为１８０±０．６８、１．６４±０．４２，两者Ｐ＞０．０５。^(９９ｍ)Ｔｃ－ＭＩＢＩ乳腺双时相显像敏感性为８８％，特异性为７６％，准确性为８２％。钼靶检查：良性病变诊断的８例中，一例为恶性病变（浸润性导管癌）；病变性质无法确定的１４例中，６例为恶性病变（浸润性导管癌３例，浸润性腺癌２例，鳞癌１例）；恶性病变诊断的１２例中２例为良性病变。钼靶检查病变性质无法确定的１４例中，乳腺双时相显像诊断正确为１２例。结论：^(９９ｍ) Ｔｃ－ＭＩＢＩ乳腺双时相显像和钼靶检查对乳腺肿块的诊断和鉴别诊断中有各自的特点。在临床实践中合理的诊断程序有助于提高诊断准确率。Purpose: To evaluate whether the joint use of mammography and double - phase ^(99m) Tc - MIBI scinti- mammography were capable of improving the accuracy in diagnosis of breast lesions.Materials and Methods: 34 patients with suspected breast cancer underwent double - phase ^(99m) Tc - MIBI scintimam- mography and mammography. On mammography , all patients were examined in craniocaudal and medio- lateral oblique views. Scintimammography was performed in supine, both oblique views and prone posi- tion. In all cases histopathology diagnosis were established by surgery in two weeks. Results: Double- phase ^(99m) Tc - MIBI scintimammography had 88% sensitivity; 76% specificity and 82% accuracy. On mam- mography 8 lesions(of which one was breast cancer)were considered to be of the most probably benign; 14 (of which 6 were breast cancer) as indeterminate and 12(of which 2 were benign) as the most probably malignant. Conclusion: Double - phase ^(99m) Tc - MIBI sciotimammography and mammography had their own advantage in diagnosis of breast cancer. If they could be used reasonably in prartice , they would be helpful to improve the accuracy of diagnosis and reduce the unnecessary biopsies.

关 键 词：乳腺癌 双时机 乳腺显像 乳腺钼靶 锝99M-MIBI 

分 类 号：R730.4[医药卫生—肿瘤]