^(99)锝~m-甲氧基异丁基异腈单光子发射型计算机断层显像和计算机断层扫描对肺癌纵隔淋巴结定性诊断的比较  

Comparison of ^(99)Tc^m-MIBI SPECT and CT in the qualitative diagnosis of mediastinal lymph nodes in lung cancer

作　　者：张立广[1] 王爱辉[2] 张志民[3] 李青山[1] 高东奇[1] 张力[1] 

机构地区：[1]承德医学院附属医院肿瘤科,河北承德067000 [2]承德医学院附属医院核医学科,河北承德067000 [3]承德医学院附属医院胸外科,河北承德067000

出　　处：《中国医药导报》2014年第33期94-98,共5页China Medical Herald

基　　金：河北省承德市科学技术研究与发展计划项目(编号20132045)

摘　　要：目的对比99锝m-甲氧基异丁基异腈单光子发射型计算机断层显像和计算机断层扫描(99Tcm-MIBI SPECT/CT)同机融合亲肿瘤显像与CT对肺癌纵隔淋巴结转移定性诊断的准确性,了解99Tcm-MIBI SPECT/CT同机融合亲肿瘤显像在肺癌临床分期中的诊断价值。方法选择2012年5月~2014年3月在承德医学院附属医院治疗的28例肺癌患者,分别行99Tcm-MIBI SPECT/CT同机融合亲肿瘤显像和胸部CT,分别对纵隔淋巴结做定性诊断,并与病理诊断比较,确定99Tcm-MIBI SPECT/CT同机融合亲肿瘤显像和胸部CT对肺癌纵隔淋巴结转移定性诊断的准确性。结果 99Tcm-MIBI SPECT/CT同机融合亲肿瘤显像对肺癌纵隔淋巴结转移定性诊断的灵敏度为83.33%,特异度为89.86%,准确度为88.17%,阴性预测值为74.07%,阳性预测值为93.93%。胸部CT对肺癌纵隔淋巴结转移定性诊断的灵敏度为75.00%,特异度为72.46%,准确度为73.11%,阴性预测值为48.65%,阳性预测值为10.71%。两者灵敏度比较,差异无统计学意义(P>0.05)。SPECT/CT同机融合亲肿瘤显像的特异度、准确度、阴性预测值、阳性预测值均优于CT,两者比较差异均有统计学意义(P<0.05或P<0.01)。结论 99Tcm-MIBI SPECT/CT同机融合亲肿瘤显像对肺癌纵隔淋巴结定性诊断的准确性优于胸部CT,在肺癌的临床分期中具有重要的诊断价值。Objective To compare the accuracy of 99Tcm-MIBI SPECT/CT and CT in the qualitative diagnosis of medi- astinal lymph node metastasis of lung cancer to understand the value of 99Tcm-MIBI SPECT/CT in the clinical stage of lung cancer. Methods 28 patients with lung cancer in the Affiliated Hospital of Chengde Medical College from May 2012 to March 2014 were chosen, and were examined by 99Tcm-MIBI SPECT/CT and chest CT, the results of the quali- tative diagnosis of the mediastinal lymph nodes were compared with the pathological diagnosis, the accuracy of the 99Tcm-MIBI SPECT/CT and chest CT for the diagnosis of mediastinal lymph node metastasis was observed. Results In the 99Tcm-MIBI SPECT/CT, the qualitative diagnosis sensitivity of me diastinal lymph node metastasis was 83.33%, specificity was 89.86%, accuracy was 88.17%, the negative predictive value was 74.07%, the positive predictive value was 93.93%. In the chest CT, the qualitative diagnosis sensitivity of mediastinal lymph node metastasis was 75.00%, specificity was 72.46%, accuracy was 73.11%, the negative predictive value was 48.65%, the positive predictive value was 10.71%. There was no significant difference between the sensitivity in two methods （P 〉 0.05）. Specificity, accura- cy, the negative predictive value, the positive predictive value of SPECT/CT were better than those of CT, the differ- ences were statistically significant （P 〈 0.05 or P 〈 0.01）. Conclusion 99Tcm-MIBI SPECT/CT has important clinical value in the clinical stage of lung cancer, because of it is more accurate than the chest CT for the qualitative diagnosisof mediastinal lymph nodes.

关 键 词：肺癌 纵隔淋巴结 定性诊断 融合影像 

分 类 号：R817.4[医药卫生—影像医学与核医学]