99mTc-甲氧基异丁基异腈单光子发射型计算机断层显像联合诊断级CT融合显像在鉴别良恶性肺部病灶中的应用  

Application of technetium-99m methoxyisobutylisonitrile single photon emission computed tomography combined with diagnosis-level CT fusion imaging to differentiating benign from malignant lung lesions

作　　者：刘长江 肖本波 黄霖[3] 鄢庆州 董燕玉[4] LIU Chang-jiang;XIAO Ben-bo;HUANG Lin;YAN Qing-zhou;DONG Yan-yu(Department of Nuclear Medicine,Xingyi People′s Hospital,Xingyi 562400,China;Department of Respiratory Medicine,Xingyi People′s Hospital,Xingyi 562400,China;Department of Diagnostic Imaging,Xingyi People′s Hospital,Xingyi 562400,China;Medical Examination Center,Xingyi People′s Hospital,Xingyi 562400,China)

机构地区：[1]贵州省兴义市人民医院核医学科,兴义市562400 [2]贵州省兴义市人民医院呼吸科,兴义市562400 [3]贵州省兴义市人民医院影像科,兴义市562400 [4]贵州省兴义市人民医院体检中心,兴义市562400

出　　处：《广西医学》2020年第24期3201-3204,共4页Guangxi Medical Journal

摘　　要：目的分析99mTc-甲氧基异丁基异腈单光子发射型计算机断层显像(99mTc-MIBI-SPECT)联合诊断级CT融合显像在鉴别良恶性肺部病灶中的应用价值。方法回顾分析63例可疑肺癌病灶患者的99mTc-MIBI-SPECT联合诊断级CT同机融合显像资料,总结良恶性肺部病灶的影像特征,并比较良恶性肺部病灶的放射性摄取比。以病理结果或临床诊断为金标准,分析99mTc-MIBI-SPECT联合诊断级CT融合显像对良恶性肺部病灶的鉴别效能。结果63例可疑恶性肺部病灶患者中,44例为恶性肺部病变,19例良性肺部病变。99mTc-MIBI-SPECT联合诊断级CT同机融合显像对肺部病灶良恶性鉴别诊断灵敏度为95.45%、特异性为84.21%、准确性为92.06%、阳性预测值为93.33%、阴性预测值为88.89%。恶性肺部病灶放射性摄取比高于良性病灶(P<0.05)。中央型恶性肺部病灶主要表现为肺门肿块放射性浓聚,而周围型恶性肺部病灶出现分叶征、毛刺、血管集束征、胸膜凹陷征的概率,以及肺部病灶呈灶性放射性浓聚的概率也高于周围型良性肺部病灶(均P<0.05)。结论99mTc-MIBI-SPECT联合诊断级CT融合显像对可疑恶性肺部病灶性质有较高的鉴别价值。SPECT影像表现为灶性放射性浓聚者多为恶性肺部病灶,对于CT影像有恶性征象者应注意随访。Objective To analyze the application value of technetium-99 m methoxyisobutylisonitrile single photon emission computed tomography(99 mTc-MIBI-SPECT)combined with diagnosis-level CT fusion imaging in differentiating benign from malignant lung lesions.Methods The data of 99 mTc-MIBI-SPECT combined with diagnosis-level coincidence CT fusion imaging of 63 suspected lung cancer patients were retrospectively analyzed,the image features of benign and malignant lung lesions were summarized,and the radioactive uptake ratios of benign and malignant lung lesions were compared.Pathological findings or clinical diagnostic results served as the gold standard to analyze the efficiency of 99 mTc-MIBI-SPECT combined with diagnosis-level CT fusion imaging for differentiating benign from malignant lung lesions.Results Among the 63 cases of suspected malignant lung lesions,44 were malignant and 19 were benign lung lesions.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of 99 mTc-MIBI-SPECT combined with diagnosis-level coincidence CT fusion imaging were 95.45%,84.21%,92.06%,93.33%and 88.89%,respectively,for differentiating benign from malignant lung lesions.Malignant lung lesions exhibited higher radioactive uptake ratio than benign lesions(P<0.05).Central malignant lung lesions were commonly manifested as hilar mass radioactive concentration,whereas peripheral malignant lung lesions had higher probability of lobulation sign,spicule sign,vascular bundle sign and pleural indentation sign than peripheral benign lung lesions,along with higher probability of pulmonary lesions showing focal radioactive concentration(all P<0.05).Conclusion 99 mTc-MIBI-SPECT combined with diagnosis-level CT fusion imaging exhibits higher differential value for suspected malignant lung lesions.Most patients with focal radioactive concentration on SPECT images have malignant lung lesions,and more attention should be paid to the follow-up of those with malignant signs on CT images.

关 键 词：肺部病灶 99mTc-甲氧基异丁基异腈单光子发射型计算机断层显像 诊断级CT 融合显像 定性诊断 诊断效能 

分 类 号：R817.4[医药卫生—影像医学与核医学]