^(99)Tc^n-MIBI乳腺显像在鉴别乳腺肿瘤良恶性及腋窝淋巴结转移的临床应用研究  

Investigation of ^(99) Tc^m-MIBI Imaging in Differential Diagnosis of Breast Masses and in Detection of Metastatic Axillary Lymph Node

作　　者：李林法[1] 刘小焦[2] 吴福生[3] 朱阳军[1] 

机构地区：[1]浙江大学医学院附属第一医院核医学科,浙江杭州310003 [2]浙江大学医学院附属第一医院外科,浙江杭州310003 [3]浙江大学医学院附属第一医院肿瘤科,浙江杭州310003

出　　处：《中国医学影像技术》2003年第4期426-428,共3页Chinese Journal of Medical Imaging Technology

摘　　要：目的　评价99Tcm 甲氧基异丁基异腈 (MIBI)显像在判断乳腺肿块良、恶性及诊断腋窝转移淋巴结中的价值。方法　采用自制乳腺显像装置 ,经病变乳腺对侧肘静脉注射99Tcm MIBI 5 5 5～ 740MBq后 15min即行早期乳腺显像 ,分别采集正前位、左、右侧位像 ,采集计数 10 0 0k ,1.5h后按上述条件作延迟显像。结果　 3 4例乳腺肿块患者 ,99Tcm MIBI核素显像阳性2 2例 ,阴性 12例 ;2 4例乳腺癌患者99Tcm MIBI核素显像阳性 2 0例、阴性 4例 ;10例良性病变中99Tcm MIBI核素显像阴性 8例、阳性 2例 ;99Tcm MIBI核素显像诊断乳腺癌的灵敏度为 83 .3 % ,特异性 80 .0 % ,准确性为 82 .4% ,阳性预测值 90 .9% ,阴性预测值 66.7% ;99Tcm MIBI核素显像对腋窝淋巴结转移检出的灵敏度为 80 .0 % ,特异性为 92 .9% ,阳性预测值 88.9% ,阴性预测值为 86.7% ,准确性为 87.5 %。结论　99Tcm MIBI显像对触及乳腺肿块的患者能提供非常有价值的临床信息 ,能较好地鉴别诊断乳腺肿块的良、恶性。Objective To evaluate prospectively the sensitivity and specificity of 99 Tc m MIBI scintimammography in the differential diagnosis of breast masses and the metastasis axillary lymph node in breast cancer. Methods The 555～750MBq 99 Tc m MIBI was injected into an antecubital vein contralateral to the palpable breast lesion.The early and delay images were acquired at 15min and 1.5h after injection of the tracer.The imaging was performed using special designed imaging device made by ourselves.Three planar views,right and left lateral and anterior views including both axillae were obtained.The acquisition counts should be reached 1000k. Results Of the 34 cases,22 patients' 99 Tc m MIBI images were positive,and 12 images negitive.There were 20 true positive,4 false negitive in 24 malignants imaging.And 2 false positive,8 true negitive in 10 benigns.The sensitivity of 99 Tc m MIBI images in diagnosis of breast cancer was 83.3%,and the specificity was 80.0%,the positive and the negative predictive values were 90.9% and 66.7%,the accuracy was 82.4%.The sensitivity of scintimammography in detecting metastatic axillary lymph node was 80.0%,and the specificity was 92.9%,the positive and the negative predictive values were 88.9% and 86.7%,the acuracy was 87.5%. Conclusion 99 Tc m MIBI images provides clinically valuable information on patients with palpable breast masses. 99 Tc m MIBI scintigraphy of breast can well differential between malignant and benign masses,but the sensitivity for lesions was related to the tumor size in some degree.

关 键 词：^99Tc^m-甲氧基异丁基异睛 ^99TC^M-MIBI 乳腺显像 鉴别 乳腺肿瘤 良性 恶性 腋窝转移淋巴结 放射性核素显像 

分 类 号：R730.44[医药卫生—肿瘤] R737.9[医药卫生—临床医学]