乳腺99Tc^m-MIBI闪烁显像和X线摄影诊断乳腺癌的临床价值比较研究  

Comparison of clinical value of breast 99Tc^m-MIBI scintigraphy and mammography for diagnosis of breast cancer

作　　者：刘洪彪[1] 占宏伟[1] 孙达[1] 张莺[1] 王丽华[2] Liu Hongbiao;Zhan Hongwei;Sun Da;Zhang Ying;Wang Lihua(Department of Nuclear Medicine,The Second Affiliated Hospi tal,Zhejiang University School of Medicine,Hangzhou 310009,China;Department of Radiology,The Second Affiliate d Hospital,Zhejiang University School of Medicine,Hangzhou 310009,China)

机构地区：[1]浙江大学医学院附属第二医院核医学科,浙江杭州310009 [2]浙江大学医学院附属第二医院放射科,浙江杭州310009

出　　处：《实用肿瘤杂志》2020年第4期360-366,共7页Journal of Practical Oncology

摘　　要：目的评估乳腺专用伽玛显像(breast specific gamma imaging,BSGI)在乳腺癌探查中作为乳腺X线辅助的诊断能力。方法回顾性分析因乳腺结节/肿块住院的169例女性患者的BSGI和乳腺X线显像结果,并与病理学检查结果作对照。结果169例188个病灶中,86例91个病灶为乳腺恶性肿瘤,83例97个病灶为乳腺良性病变。BSGI有8个病灶为假阴性,其中6个病灶的肿瘤与正常组织的放射性计数比值(lesion to normal tissue ratio,L/N)<1.4,26个病灶为假阳性(24个病灶L/N>1.5)。良、恶性组间比较显示,乳腺恶性肿瘤组L/N为(2.62±1.35),高于良性病灶组的(1.61±0.36),差异具有统计学意义(P<0.05)。乳腺X线显像假阴性和假阳性病灶各23个病灶。BSGI检查的敏感度和阴性预测值分别为91.2%和90.0%,高于乳腺X线检查的74.7%和76.3%(均P<0.05)。BSGI与乳腺X线检查的特异度(73.2%vs 76.3%)和阳性预测值(76.1%vs 74.7%)相近。BSGI和乳腺X线检查结合使敏感度、准确度和阴性预测值又有所增加,分别为93.4%、82.4%和92.1%。结论在乳腺癌诊断中,与乳腺X线检查比较,BSGI显示出更高的敏感度、准确度和阴性预测值。BSGI作为功能性显像方法和辅助手段可以在评估乳腺癌中起重要作用。Objective To evaluate the diagnostic capability of breast specific gamma imaging(BSGI)as an adjunct imaging modality for the detection of breast cancer.Methods The BSGI and mammography results of 169 female patients hospitalized for breast nodules/mass were restrospectively analyzed,and compared with the pathological findings.Results Among 169 patients with 188 lesions,91 lesions in 86 cases were breast malignant tumors and 97 lesions in 83 cases were benign breast lesions.BSGI had 8 lesions with false negative and 26 lesions with false positive.Average lesion to normal tissue ratio(L/N)in malignant tumors was significantly higher than that in benign lesions[(2.62±1.35)vs(1.61±0.36),P<0.05].There were 23 false negative and 23 false positive lesions in mammography.The sensitivity and negative predictive value of BSGI were higher than those of mammography(91.2%vs 74.7%,and 90.0%vs 76.3%,respectively,both P<0.05).The specificity and positive predictive value of BSGI were similar to those of mammography(73.2%vs 76.3%,and 76.1%vs 74.7%,respectively).The combination of BSGI and mammography increased the sensitivity,accuracy and negative predictive value(93.4%,82.4%,and 92.1%),respectively.Conclusions In the diagnosis of breast cancer,BSGI has higher sensitivity,accuracy and negative predictive value compared to mammography.BSGI may play an important role as an efficient functional imaging and an adjunct tool for the diagnosis of breast cancer.

关 键 词：乳腺肿瘤/影像诊断 99m锝甲氧基异丁基异腈/诊断应用 乳房X线摄影术 评价研究 回顾性研究 

分 类 号：R737.9[医药卫生—肿瘤] R730.4[医药卫生—临床医学]