99Tcm-MIBI显像与钼靶X线对乳腺癌诊断的比较研究  

Diagnostic value of technetium 99Tcm sestamibi and X-ray mammography in breast cancer： a comparison study

作　　者：杨雷[1,2] 袁卫红[1] 王家平[1] 高佳乐[3] 杨青[2] 赵莉莉[1] 张怡[2] 曾志[2] 王丽娟[2] 岳江红[2] 

机构地区：[1]昆明医科大学第二附属医院核医学科,650101 [2]昆明医科大学第二附属医院放射科,650101 [3]昆明医科大学公共卫生学院统计专业,650500

出　　处：《国际放射医学核医学杂志》2016年第2期111-114,共4页International Journal of Radiation Medicine and Nuclear Medicine

基　　金：云南省教育厅科研基金项目（08Y0232）

摘　　要：目的 比较99Tcm-MIBI SPECT/CT显像和钼靶X线对女性乳腺癌的诊断价值.方法 女性患者83例,先行99Tcm-MIBI胸部SPECT/CT早期显像和延迟显像,并以延迟显像阳性为判定标准,再行乳腺钼靶X线摄影,并与最终的病理结果进行对照.结果 延迟显像的阳性患者为52例（T/NT值＞3.33）,阳性与阴性病灶的早期、延迟显像分别比较,差异均有统计学意义,且以延时2h结果更为显著,最终病理结果证实45例为恶性病灶.99Tcm-MIBI显像结果的灵敏度为93.33％、特异度为73.68％、阳性预测值为80.77％、阴性预测值为90.32％;而钼靶X线对于相同病灶的灵敏度、特异度分别为64.44％、73.68％,阳性、阴性预测值分别为74.36％、63.63％.99Tcm-MIBI显像对乳腺癌诊断价值优于钼靶X线（x2=4.11,P＜0.05）,但两种方法的一致性较差（Kappa=0.217,P＜0.05）.结论 99Tcm-MIBI显像较之钼靶X线的结果判定更为客观,而两种方法同时运用则能提高乳腺癌的检出率,显著提高影像学对于乳腺癌的早期诊断.Objective To compare the diagnostic value of 99Tcm-MIBI SPECT/CT chest imaging combined with X-ray mammography and to investigate their complementarity.Methods This study included 83 female patients,including those suspected to have breast nodules and those diagnosed with breast cancer.All patients were examined initially via 99Tcm-MIBI chest SPECT/CT imaging and delayed imaging followed by X-ray mammography,and all data were compared with final pathological results.Results Among the 99TTcm-MIBI imaging results of the 83 female patients,52 lesions were revealed by delay images （T/NT ratio 〉3.33）.The final criterion for diagnosis was based on positive delay imaging.The T/NT ratio between benign and malignant breast lesions was statistically significant （P〈0.05）.The sensitivity,specificity,positive predictive value and negative predictive value of diagnosis via 99TTcm-MIBI SPECT/CT chest imaging were 93.33%,73.68%,80.77%,and 90.32%,respectively.The scnsitivity,specificity,positive predictive value and negative predictive value of X-ray were 64.44%,73.68%,74.36%,63.63%,respectively.99Tcm-MIBI imaging superior value to diagnosis X-ray mammogragh for breast cancer（X2=4.11,P〈0.05）,but two methods of consistency spreads（Kappa=0.217,P〈0.05）.Conclusions The sensitivity and specificity of 99Tcm-MIBI were higher than those of X-ray mammography in diagnosis of early-stage breast cancer.99Tcm-MIBI imaging offers advantages in detecting virus infection aslar-pacific nodules.It is speculated that detecting regular breast nodules and occult lesions can be improved if these two methods are combined because they are complementary techniques.

关 键 词：乳腺肿瘤 99M锝甲氧基异丁基异腈 乳房X线摄影术 

分 类 号：R737.9[医药卫生—肿瘤]