^99mTc-MIBI显像诊断乳腺癌及腋窝淋巴结转移的临床价值  

The clinic diagnostic value of ^99mTc-MIBI imaging for breast cancer and axillary lymph node metastasis

作　　者：曾贤伍[1] 董峰[1] 杨碎胜[2] 张斌明[2] 达选祯[1] 李文燕[1] 

机构地区：[1]甘肃省肿瘤医院核医学科,甘肃兰州730050 [2]甘肃省肿瘤医院乳腺外科,甘肃兰州730050

出　　处：《甘肃医药》2012年第11期801-805,共5页Gansu Medical Journal

基　　金：甘肃省科技支撑项目(编号:090NKCA090)

摘　　要：目的:应用ROC曲线分析99mTc-MIBI显像诊断乳腺癌及腋窝淋巴结转移的临床价值。方法:44例乳腺肿瘤患者行99mTc-MIBI早期、延迟平面显像和断层显像,利用计算机感兴趣区(ROI)技术,计算靶/非靶比值(T/N),半定量分析和ROC曲线分析结果。结果:本组44例患者细针穿刺或术后病理结果证实29例为恶性病变,15例为良性病变。恶性组在早期、延迟平面显像、断层显像T/N比值分别为1.76±0.73、1.64±0.56和3.31±1.93,良性组为1.19±0.31、1.18±0.30和1.24±0.39,良、恶性组之间均有显著性差异(P<0.01),肿瘤摄取指数(UI)分别为-0.01±0.0和-0.05±0.10,良、恶性组之间无显著性差异(P>0.05);恶性组断层显像T/N比值>延迟显像T/N比值>早期显像(P<0.01),而良性组则无明显变化(P>0.05);ROC曲线分析确定诊断乳腺癌阈值,早期相:1.26,延迟相:1.21和断层显像:1.52。诊断腋窝淋巴结转移的阈值:1.40。99mTc-MIBI显像诊断乳腺癌的灵敏度、特异性、准确率分别为:早期相:75.86%、80.0%及77.27%;延迟相:79.31%、80.0%及79.55%;断层显像:86.21%、80.0%及84.09%,SPECT/CT断层显像诊断腋窝淋巴结转移的灵敏度、特异性、准确率分别为:83.3%、64.7%和72.4%。结论:99mTc-MIBISPECT/CT显像诊断乳腺癌及腋窝淋巴结转移具有较高的临床价值。Objective：To assess the clinic diagnostic value of ^99mTc-MIBI imaging for breast cancer and axillary lymph node metastasis using receiver operating characteUIstic （ROC） curve analysis. Methods：Forty-four patients with brast tumor underwent early phase and delayed phase planar and tomography imaging after injection of 99m Tc-MIBI. Regions of interest （ROI） were down on the tumor （T） and normal （N） ,T/N ratios were measured for all scans. The results of analysis by semi-quantitative and ROC curve. Results：The fifty-four patients with the breast tumor were confirmed by the pathologic histology after operation or fine needle aspiration （FNA） ,twenty-nine patients were malignant lesion ,fifteen patients were benign lesion.T/N ratios at early phase,delayed phase, tomography imaging and tumor uptake index （UI） in maligant group were 1.76±0.73,1.64±0.56,3.31±1.93 and-0.01±0.06, respectively. While in benign group,they were 1.19 ±0.31,1.18 ±0.30,1.24 ±0.39 and -0.05 ±0.10,respectively,there were obviously significantly difference in the early phase ,delayed phase planar,tomography imaging T/N ratios between maligant and benign group （ P〈0.01） ,but tumor uptake index （UI） was no significantly difference.In maligant group ,tomography imaging T/N ratios high than the delayed phase and early phase （ P〈0.05） ,howerver, there were no obviously significantly difference in benign group（ P〈0.05） . The T/N ratios diagnostic threshold of breast cancer decided from ROC curve ,the early phase, delayed phase and tomography imaging were 1.26,1.21 and 1.52,respectively. The sensitivity; specificity and accuracy of the early phase were 75.86% ,80.0% and 77.27% , delayed phase：79.31% ,80.0% and 79.55% ,tomography imaging：86.21% 、80.0% and 84.09% respectively,there were no obviously significantly difference between the early phase,delayed phase planarn and tomography imaging. The tomography imaging T/N ratios diagnostic threshold of axillary lymph node metastasis was 1.40,th

关 键 词：99m锝-MIBI 乳腺癌 腋窝淋巴结 放射性核素显像 

分 类 号：R541.4[医药卫生—心血管疾病]