^(99m)Tc-MIBI脑显像评价胶质瘤恶性程度  

^(99m)Tc-MIBI brain imaging in evaluating the malignant grade of gliomas

作　　者：韩星敏[1] 刘保平[1] 孙红卫[2] 孙秉奇[1] 常建东[1] 

机构地区：[1]河南医科大学第一附属医院核医学科,郑州450052 [2]河南医科大学第一附属医院神经外科,郑州450052

出　　处：《河南医科大学学报》2001年第2期167-170,共4页Journal of Henan Medical University

摘　　要：目的 :评价99mTc MIBI脑显像判断胶质瘤恶性程度的价值。方法 :受检查者共 32例 ,其中胶质瘤 2 4例 ,均经CT或MRI检查 ,确定肿瘤部位 ,正常对照 8例。于静脉注射99mTc MIBI 5 5 5～ 740MBq(15～ 2 0mCi)后 15～ 30min(earlyphase,EP)和 2～ 3h(delayedphase ,DP)分别进行单光子发射型计算机断层 (SPECT)显像。采用病变部位的平均放射性计数除以对侧相应部位的平均放射性计数 (T/C)和病变部位的平均放射性计数除以脉络丛部位的平均放射性计数 (T/CP)两种半定量的方法判断胶质瘤摄取99mTc MIBI的程度。根据术后组织病理学检查 ,采用Kernohan分类法 ,将患者分为低级 (low grade ,LG)恶性 (包括Ⅰ级和Ⅱ级 ) 13例和高级 (high grade ,HG)恶性 (包括Ⅲ级和Ⅳ级 )11例 2组。结果 :在EP中 ,LG组与HG组的T/C值分别为 (1 0 6± 0 31)和 (2 6 5± 0 85 ) ,两组之间差异有显著性。以 1 6为界限 ,鉴别LG与HG的灵敏度、特异度和准确性分别为 90 %、10 0 %和 95 %。结论 :99mTc MIBI脑显像可作为一种无创性的术前评价胶质瘤恶性程度的方法。Aim: To evaluate technetium-99m Methoxyisobutylisonitrile ( 99mTc-MIBI)brain imaging in assessing the malignant grade of gliomas.Methods:Single photon emission computed tomography(SPECT)with 99m Tc-MIBI was carried out in 24 patients with gliomas prior to surgical resection and 8 for controls.Patients had been detected by Computed Tomography or Magnetic Resonance Imaging to localize the tumor.SPECT was performed 15～30 min(early phase,EP)and 2～3 h(delayed phase,DP) after administration of 555～740MBq(15～20 mCi) of 99m Tc-MIBI respectively.Two 99m Tc-MIBI uptake indexes by gliomas were calculated as the ratio of the average counts per pixel in the tumor(T) over the average counts per pixel in the contralateral region (T/C) and the ratio of the T/CP(choroid plexus)both of EP and DP.Patients were divided into 2 groups:low-grade(LG)and high-grade(HG)malignant gliomas.Histological diagnoses were confirmed by examination of neoplastic tissues according to Kernohan classification.A total of 13 patients with grade Ⅰ or Ⅱ were grouped as LG,and 11 with grade Ⅲ or Ⅳ as HG.Results:In EP,the T/C of LG and HG were (106±031) and (265±085) respectively.Significant difference was found between LG and HG.Using a threshold index of 1.6 to distinguish LG versus HG,the sensitivity,specificity and accuracy were 90%,100%,and 95% respectively.Conclusion:This study suggests that 99m Tc-MIBI brain imaging,as a noninvasive preoperative technique,is of value in assessment of the malignancy grade of gliomas.

关 键 词：脑肿瘤 胶质瘤 放射性核素显像 锝 腈类L 

分 类 号：R739.41[医药卫生—肿瘤] R730.44[医药卫生—临床医学]