^(99m)Tc(V)-DMSA显像在肢体软组织肿瘤诊断中的应用  

Application of ^(99m)Tc(V)-DMSA imaging in diagnosis of limb soft tissue tumors

作　　者：梁鹏[1] 曾贤伍[2] 董峰[2] 宋建民[1] 陈学忠[3] 齐江华[1] 李文燕[2] 

机构地区：[1]甘肃省肿瘤医院骨与软组织肿瘤科,兰州730050 [2]甘肃省肿瘤医院核医学科,兰州730050 [3]甘肃省肿瘤医院胸外科,兰州730050

出　　处：《国际骨科学杂志》2014年第4期254-256,271,共4页International Journal of Orthopaedics

基　　金：甘肃省科技厅技术与开发专项计划项目(0912TCYA007)

摘　　要：目的探讨99m锝(V)-二巯基丁二酸﹝99mTc(V)-DMSA﹞显像在肢体软组织肿瘤诊断中的临床价值。方法 2008年2月至2011年12月,对54例肢体软组织肿瘤患者(恶性肿瘤组34例,良性病变组20例)行99mTc(V)-DMSA早期平面显像(30 min)、延迟平面显像(2 h)和延迟断层显像(2 h),应用计算机感兴趣区(ROI)技术,计算肿瘤部位与正常肢体软组织放射性计数比值(T/N比值),并分析T/N比值在肢体软组织肿瘤诊断中的价值。结果恶性肿瘤组平均早期平面显像T/N比值、延迟平面显像T/N比值和延迟断层显像T/N比值分别为2.04±0.74、2.48±0.85、3.32±1.14,良性病变组分别为1.10±0.31、1.23±0.49、1.52±0.32,两组早期平面显像T/N比值、延迟平面显像T/N比值、延迟断层显像T/N比值具有显著性差异(P<0.05),两组肿瘤滞留指数(RI)亦具有显著性差异(P=0.009)。良性病变组以延迟断层显像T/N比值x+1s为截断点,99mTc(V)-DMSA显像诊断肢体软组织肿瘤灵敏度、特异度、准确度分别为88.24%(30/34)、75%(15/20)、83.34%(45/54);以RI x+1s为截断点,99mTc(V)-DMSA显像诊断肢体软组织肿瘤灵敏度、特异度、准确度分别85.29%(29/34)、75%(15/20)、81.48%(44/54)。结论 99mTc(V)-DMSA显像对于肢体软组织肿瘤诊断及肿瘤良恶性鉴别具有较高的临床价值。Objective To investigate the clinical value of 99mTc(V)-dimercaptosuccinic acid[99mTc(V)-DMSA]imaging in diagnosis of limb soft tissue tumors.Methods From February 2008 to December 2011,54 patients(34 malignant tumors,20 benign tumors)with limb soft tissue tumor underwent early planar imaging(30 min),delayed planar imaging(2 h)and delayed tomography fusion imaging(2 h)after injection of 99mTc(V)-DMSA.Tumor to normal limb soft tissue(T/N)ratio which based on regions of interest(ROI)setting technology was calculated,and T/N ratio in diagnosis of limb soft tissue tumors was evaluated.Results T/N ratio of early planar imaging,delayed planar imaging and delayed tomography fusion imaging in malignant group were 2.04±0.74,2.48±0.85,3.32±1.14,respectively.While T/N ratio of early planar imaging,delayed planar imaging and delayed tomography fusion imaging in benign group were 1.10±0.31,1.23±0.49,1.52±0.32,respectively.T/N ratio of early planar imaging,delayed planar imaging and delayed tomography fusion imaging between benign group and malignant group were obvious difference(P<0.05),and there was obvious difference in the tumor uptake ratio indexes(RI)(P=0.009).Using T/N ratio(x+1s)of delayed tomography fusion imaging as diagnostic threshold in benign group,the sensitivity,specificity and accuracy rate in diagnosis of limb soft tissue tumors were 88.24%(30/34),75%(15/20)and 83.34%(45/54),respectively.Using RI(x+1s)as diagnostic threshold,the sensitivity,specificity and accuracy rate in diagnosis of limb soft tissue tumors were 85.29%(29/34),75%(15/20)and 81.48%(44/54),respectively.Conclusions 99mTc(V)-DMSA imaging has high clinical reference value for diagnosis of limb soft tissue tumors,and it is discerning malignant tumors from benign tumors.

关 键 词：^99m锝(V)-二巯基丁二酸 肢体软组织肿瘤 放射性核素显像 

分 类 号：R738.6[医药卫生—肿瘤]