地塞米松介入延迟骨显像鉴别良恶性骨病变  

Preliminary study of 24 h bone scintigraphy after dexamethason intervention for differentiating the benign from malignant bone lesions

作　　者：范洋[1] 李亚明[1] 韩春起[1] 李德顺[1] 马爱萍[1] 梁辰荣[1] 孙振秋[1] 刘浩[1] 孙晓蓉[1] 尹雅芙[1] 

机构地区：[1]中国医科大学附属第一临床学院核医学科,沈阳110001

出　　处：《中华核医学杂志》2001年第6期351-352,共2页Chinese Journal of Nuclear Medicine

摘　　要：目的　探讨地塞米松介入 2 4h延迟骨显像鉴别良、恶性骨病变的临床价值。方法　 2 0例恶性骨病变患者 (共 2 42个病灶 )、2 1例良性骨病变患者 (共 10 2个病灶 )随机分成非介入组和介入组进行对照研究。非介入组于注药后 3、2 4h分别进行骨显像 ,介入组于 3h显像后分次口服醋酸地塞米松片共 6 .75mg ,于 2 4h行骨显像。勾划ROI,计算 2 4h 3h放射性摄取比值 (RUR)。结果　非介入组与介入组良性病变间的RUR值差异无显著性 (q=0 .94,P >0 .0 5 ) ;非介入组与介入组的恶性病变之间、非介入组的良性病变与恶性病变之间、介入组的良性病变与恶性病变之间RUR值的差异均有显著性 (q分别为 2 0 .10 ,1.81,16 .39,P分别 <0 .0 1,<0 .0 5 ,<0 .0 1)。非介入组RUR值判别恶性骨病变的灵敏度、特异性、准确性分别为 75 .5 %、86 .2 %、6 5 .8% ,介入组分别为 81.5 %、87.5 %、83 1%。结论　口服地塞米松介入 2 4h延迟骨显像可明显提高骨显像的诊断效能 ,方法简便易行 ,具有临床应用价值。Objective To explore the clinical value of 24 h bone scintigraphy after dexamethason intervention for differentiating the benign and malignant bone lesions. Methods Twenty patients with malignant bone lesion (242 foci) and 21 patients with benign bone lesion (102 foci) were randomly divided into non-intervention group and intervention group for the comparative study. The patients in the non-intervention group underwent bone scintigraphy 3 and 24 h after the tracer administration, while the patients in the intervention group were given dexamethason 6.75 mg orally after 3 h bone imaging, then underwent 24 h bone imaging. Different regions of interest were drawn in 3 and 24 h imaging,then the radionuclide uptake ratios (RUR) of 24 h to 3 h was calculated. Results There were no significant differences in RUR of benign lesions between the non-intervention group and intervention group ( q=0.94,P >0.05). There were significant differences in RUR between the malignant lesions in the non-intervention group and that in the intervention group (q=20.10, P <0.01); there were significant differences in RUR between the benign and the malignant lesions in the non-intervention group ( q=1.81,P <0.05); and there were also significant differences in RUR between the benign and the malignant lesions in the intervention group ( q=16.39, P <0.01). The sensitivity, specificity and accuracy of differentiating the benign and malignant bone lesions by RUR with non-intervention and intervention were 75.5%, 86.2%, 65.8% and 81.5%, 87.5%, 83.1%, respectively. Conclusions Comparing with the routine bone imaging, 24 h bone scintigraphy after dexamethason intervention elevated the diagnosis efficiency for differentiation of the benign and malignant bone lesions. 24 h bone scintigraphy associated with dexamethason intervention is convenient and acceptable in differentiation of benign and malignant bone lesions, and it is proved to be of great value for clinical application.

关 键 词：放射性核素显像 地塞米松 鉴别诊断 骨肿瘤 

分 类 号：R817.4[医药卫生—影像医学与核医学]