腮腺99TcmO4-摄取指数和残留比诊断干燥综合征的价值  

Diagnostic value of 99Tcm-pertechnetate salivary gland scintigraphy in patients with Sj？gren′s syndrome

作　　者：田甜[1] 韦智晓[1] 李俊红[1] 彭盛梅[1] 李秀琼[1] 刘良森[1] 张筱楠[1] 刘学[1] 

机构地区：[1]广西医科大学第一附属医院核医学科,南宁530021

出　　处：《中华核医学与分子影像杂志》2016年第6期521-524,共4页Chinese Journal of Nuclear Medicine and Molecular Imaging

基　　金：广西医疗卫生适宜技术研究与开发项目（S201415-06）

摘　　要：目的 探讨唾液腺显像中腮腺第10分钟摄取指数（UR10 min）和残留比诊断干燥综合征（SS）的价值。方法 回顾性分析94例SS患者[男9例、女85例，平均年龄（48±13）岁]和60例非SS患者[对照组；男14例、女46例，平均年龄（46±13）岁]的唾液腺显像结果，根据腮腺显影程度和酸刺激后腮腺影减淡程度将94例SS患者分为3组：A组，功能正常15例，轻度损伤7例；B组，功能中度损伤，56例；C组，功能重度损伤，16例。勾画腮腺和颞叶本底ROI，计算腮腺UR10 min和残留比，利用单因素方差分析、q检验和ROC曲线评价UR10 min和残留比诊断SS的价值。结果 对照组、A组及B组UR10 min明显高于C组（1.48±0.43、1.56±0.38、1.38±0.55、0.53±0.21；F＝20.3，q值：15.8、7.9和8.5，均P〈0.05）。对照组残留比明显小于其他3组（0.63±0.08、0.83±0.14、1.14±0.08、1.09±0.08，F＝315.0，q值：14.3、41.0和32.8，均P〈0.05），且A组残留比小于B组和C组（q值：31.0和13.0，均P〈0.05）。UR10 min的ROC AUC为0.62，残留比AUC为0.97。结论 腮腺UR10 min对晚期SS诊断灵敏，腮腺残留比对早期SS诊断灵敏，建议将残留比作为判断唾液腺功能损伤的定量诊断指标。Objective To investigate the diagnostic value of the residual ratio and the ratio of 99Tcm-pertechnetate uptake at 10 min （UR10 min） in patients with Sj？gren′s syndrome （SS）.Methods The retrospective study included 94 cases of SS （9 males, 85 females; average age （48±13） years） and 60 cases of non-SS （control group; 14 males, 46 females, average age （46±13） years）. All patients underwent 99Tcm-pertechnetate salivary gland scintigraphy. According to the uptake of 99Tcm-pertechnetate in parotid gland, 94 SS patients were divided into 3 groups： group A including 15 normal cases and 7 cases with mild injury, group B including 56 cases with moderate injury, and group C including 16 cases with severe injury. ROI was drawn, then UR10 min and the residual ratio of 99Tcm-pertechnetate in parotid gland were calculated. One-way analysis of variance, q test and ROC curve analysis were used.Results UR10 min in control group, group A and group B（1.48±0.43, 1.56±0.38, 1.38±0.55, respectively） was significantly higher than that of group C （0.53±0.21; F=20.3, q values： 15.8, 7.9, 8.5, all P〈0.05）. The residual ratio of parotid gland in control group（0.63±0.08）was significantly lower than those of the SS patients in the 3 groups （0.83±0.14, 1.14±0.08, 1.09±0.08 respectively, F=315.0, q values： 14.3, 41.0, 32.8, all P〈0.05）. The residual ratio in group A was lower than that in group B and group C（q values： 31.0, 13.0, both P〈0.05）. The AUC of ROC curve was 0.62 for UR10 min and 0.97 for residual ratio.Conclusions The UR10 min of parotid gland is sensitive for the diagnosis of the advanced SS, while the residual ratio is sensitive for the diagnosis of the early SS. Residual ratio could be a quantitative parameter to detect the function of parotid gland.

关 键 词：干燥综合征 腮腺 放射性核素显像 99m锝高锝酸钠 

分 类 号：R593.2[医药卫生—内科学]