^(99)Tc^(m)-DX淋巴显像诊断淋巴管肌瘤病肺外病变  

^(99)Tc^(m)-DX lymphoscintigraphy in detecting extra-pulmonary lesions of lymphangioleiomyomatosis

作　　者：文哲 童冠圣 刘勇[2] 张丽 李思源 郑朋腾 张硕伦 WEN Zhe;TONG Guansheng;LIU Yong;ZHANG Li;LI Siyuan;ZHENG Pengteng;ZHANG Shuolun(Department of Nuclear Medicine,Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China;Department of Sonography,Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China)

机构地区：[1]首都医科大学附属北京世纪坛医院核医学科,北京100038 [2]首都医科大学附属北京世纪坛医院超声科,北京100038

出　　处：《中国医学影像技术》2021年第6期891-894,共4页Chinese Journal of Medical Imaging Technology

基　　金：2021年度“扬帆”计划临床技术创新项目(XMLX202113);北京市科技计划首都临床诊疗技术研究及示范应用(Z191100006619051);中国国家铁路集团有限公司科技研究开发计划项目(J2019Z604);首都医科大学附属北京世纪坛医院科研基金(2019-LB03)。

摘　　要：目的评价^(99)Tc^(m)-DX淋巴显像对淋巴管肌瘤病(LAM)肺外病变的诊断价值。方法回顾性分析经临床或病理证实的39例LAM患者的淋巴显像图像,总结该病的淋巴显像特点。结果39例LAM患者中,33例(33/39,84.62%)伴乳糜胸,^(99)Tc^(m)-DX淋巴显像可显示84.85%(28/33)的乳糜胸,表现为患侧胸部分放射性增高;16例(16/39,41.03%)伴乳糜腹,^(99)Tc^(m)-DX淋巴显像均可显示(16/16,100%),表现为腹盆部不同程度的放射性摄取增高;34例(34/39,87.18%)伴腹/盆腔淋巴管肌瘤,^(99)Tc^(m)-DX淋巴显像均可显示淋巴管肌瘤(34/34,100%),表现为髂、腰及纵隔粗大、团、串状分布的放射性摄取异常增高灶;8例(8/39,20.51%)伴下肢淋巴水肿,3例LAM伴阴囊淋巴水肿,^(99)Tc^(m)-DX淋巴显像均可显示;24例(24/39,61.54%)伴左静脉角区放射性浓聚。结论^(99)Tc^(m)-DX淋巴显像可判断LAM患者肺外病变分布,评估病情严重程度。Objective To explore the value of^(99)Tc^(m)-DX lymphoscintigraphy in detecting extra-pulmonary lesions of^(99)Tc^(m)-DX lymphangioleiomyomatosis(LAM).Methods The lymphoscintigraphic images of 39 patients with LAM diagnosed clinically or confirmed by pathology were retrospectively analyzed.The lymphoscintigraphic imaging features of LAM were observed.Results Among 39 LAM patients,33(33/39,84.62%)had chylothorax.^(99)Tc^(m)-DX lymphoscintigraphy showed chylothorax in 28 cases(28/33,84.85%),presenting as increased radioactivity in the affected side of the chest.Sixteen patients(16/39,41.03%)had chyloperitoneum and all were detected with^(99)Tc^(m)-DX lymphoscintigraphy(16/16,100%),showing different degrees of increased uptake of radioactivity in the abdomen and pelvis.^(99)Tc^(m)-DX lymphoscintigraphy showed all 34 cases(34/34,100%)of abdominal/pelvic lymphangiomyoma(34/39,87.18%),the lesions of ilium,waist and mediastinum manifested as abnormal uptake of radioactivity with thick,clusters and clusters distribution.Lower limbs lymphedemas were found in 8 patients(8/39,20.51%),among them^(99)Tc^(m)-DX lymphoscintigraphy showed 3 cases with lymphedema of scrotum.Radiation concentration on the left subclavian-jugular venous angle was detected in 24 patients(24/39,61.54%).Conclusion^(99m)Tc-DX lymphoscintigraphy could describe the distribution of extra-pulmonary lesions in LAM patients and evaluate the severity of disease.

关 键 词：淋巴管平滑肌瘤病 淋巴系闪烁造影术 乳糜胸 

分 类 号：R561[医药卫生—呼吸系统] R817.4[医药卫生—内科学]