^(99)Tc^m-HL91乳腺肿瘤乏氧显像与^(99)Tc^m-MIBI显像的对比研究  

Application of ^(99)Tc^m-HL91 hypoxia tissue imaging and ^(99)Tc^m-MIBI imaging in diagnosis of breast tumors

作　　者：封娟毅[1] 康华峰[2] 王社教[1] 宋厂义[1] 何长武[1] 

机构地区：[1]西安交通大学医学院第二附属医院核医学科,陕西西安710004 [2]西安交通大学医学院第二附属医院肿瘤科,陕西西安710004

出　　处：《实用肿瘤杂志》2015年第3期232-235,共4页Journal of Practical Oncology

基　　金：陕西省社发攻关项目[2010K14-02(21)]

摘　　要：目的探讨99 Tcm-4,9二氮3,3,10,10四甲基十二烷2,11二酮肟(99 Tcm-4,9-diaza-3,3,10,10-tetramethyldodecan 2,11-dione dioxime,99Tcm-HL91)乳腺肿瘤乏氧显像诊断乳腺肿瘤的可行性及其在乳腺肿瘤鉴别诊断中的价值。方法选择触诊发现乳腺肿块患者52例,共55个病灶,所有病灶均经术后病理证实。根据病理结果将病灶分为良性组19个病灶和恶性组36个病灶。所有病例均行99Tcm-HL91乏氧显像,其中34例患者共37个病灶行99Tcm-甲氧基异丁基异腈(99Tcm-methoxyisobutylisontrile,99Tcm-MIBI)显像。用肉眼和半定量分析法对结果进行分析。结果 (1)肉眼判断:99Tcm-HL91显像诊断乳腺癌的敏感度、特异性、准确性分别为94.4%、78.9%、89.1%;99Tcm-MIBI显像诊断敏感度、特异性、准确性分别为88.0%、75.0%、83.8%。2种方法检测敏感度和特异性差异无统计学意义(均P>0.05)。(2)半定量分析:99Tcm-HL91平面显像1、3、6小时恶性组T/N比值分别为1.36±0.34、1.49±0.38、1.57±0.38,均高于良性组(均P<0.01);99Tcm-MIBI平面显像5分钟、1小时、3小时恶性组T/N比值分别为1.33±0.35、1.29±0.22、1.18±0.15,均高于良性组(均P<0.01)。结论99Tcm-HL91乳腺肿瘤乏氧显像诊断乳腺癌有较高的敏感度和特异性,对乳腺肿瘤鉴别诊断有较高的价值。Objective To evaluate the application of 99 Tcm-4,9-diaza-3,3,10,10-tetramethyldodecan 2,11-dione dioxime（99Tcm-HL91） hypoxia tissue imaging and99Tcm-methoxyisobutylisontrile（99Tcm-MIBI） imaging in diagnosis of breast tumors. Methods Fifty-two patients（ 55 lesions） with clinically diagnosed breast tumors underwent surgical treatment; all lesions were confirmed by histopathological examination.99Tcm-HL91 imaging was performed before surgery in all patients,and99Tcm-MIBI imaging was performed in 34 patients with 37 lesions. Visual and semiquantitative analysis was applied for breast imaging. Results With pathological results as gold standard,the sensitivity,specificity and accuracy of99Tcm-HL91 imaging by visual analysis were 94. 4%,78. 9% and 89. 1%,respectively,and those of99Tcm-MIBI were88. 0%,75. 0% and 83. 8% respectively. There were no statistical differences in sensitivity and specificity between two methods. Semiquantitative analysis showed that the T / N ratios of99Tcm-HL91 at 1,3 and 6 h planar for malignant group（ 36 lesions） were 1. 36 ± 0. 34,1. 49 ± 0. 38 and 1. 57 ± 0. 38,respectively,which were significantly higher than those for benign group（ 19 lesions）. The T / N ratios of99Tcm-MIBI at 5 min,1 h and 3 h planar were 1. 33 ± 0. 35,1. 29 ± 0. 22 and1. 18 ± 0. 15 respectively in malignant group,which were significantly higher than those in benign group. Conclusion99Tcm-HL91 imaging shows high sensitivity,specificity and accuracy in differential diagnosis of breast cancer from benign breast tumors.

关 键 词：乳腺肿瘤/放射性核素显像 造影剂 锝化合物/诊断应用 敏感性与特异性 诊断 鉴别 

分 类 号：R737.9[医药卫生—肿瘤] R730.44[医药卫生—临床医学]