^(99)Tc^m-MIBI显像半定量分析对乳腺癌的诊断评价  

Evaluation of ^(99) Tc^m-MIBI Scintimammography for Breast Cancer Diagnosis

作　　者：张金山[1] 李舜[1] 张家云[1] 林炎彬[1] 黄桂敏[1] 

机构地区：[1]广州医学院附属市二人民医院核医学科,广东广州510150

出　　处：《广州医学院学报》2003年第3期32-35,共4页Academic Journal of Guangzhou Medical College

摘　　要：目的 :探讨99Tcm MIBI显像半定量分析对乳腺癌的诊断价值。方法 :对 5 1例乳腺肿瘤患者术前进行99Tcm MIBI显像 (术后病理证实乳腺癌 32例 ,乳腺良性病变 1 9例 ) ,计算早期、延迟显像放射性摄取比值 (UR)和滞留指数 (RI) ,分析99Tcm MIBI显像定性和半定量判断对乳腺癌的诊断效能。结果 :①乳腺癌组的早期和延迟UR分别为 1 .5 7± 0 .2 5和 1 .5 5± 0 .2 8,乳腺良性病变组则分别为 1 .1 7± 0 .1 9和 1 .0 3± 0 .1 1 ,乳腺良性病变组两时相及组间相同时相比较P <0 .0 1 ,而乳腺癌组两时相比较P >0 .0 5 ,乳腺良性病变组RI的绝对值 (|- 0 .1 1 0± 0 .0 6 9|)大于乳腺癌组 (|- 0 .0 5 7± 0 .0 0 7|,P <0 .0 5 )。②以乳腺良性病变组延迟UR的 ( x±s)为诊断阈值对乳腺癌诊断的灵敏度、特异性和准确性分别为 93.8%、89.5 %和 92 .2 % ,高于定性判断 (分别为 87.5 %、73.7% %和82 4 % ) ,而假阳性率和假阴性率分别由 2 6 .3%和 1 2 .5 %下降到 1 0 .5 %和 6 .3%。结论 :99Tcm MIBI显像对乳腺癌的诊断效果良好 。Objective: To evaluate the value of 99 Tc m MIBI scintimammography for the diagnosis of breast cancer using semi-quantitative analysis method. Methods: A group of 51 patients with breast neoplasms confirmed by operation and pathology (including 32 patients with breast cancer and 19 with benign diseases of the breast) underwent 99 Tc m MIBI scintimammography before surgery. The uptake ratio (UR) of L/N and the retention index (RI) were calculated at 10 min and 60～90 min after injection of 740-1110 MBq 99 Tc m MIBI. Results:① The UR of breast cancer group was 1.57±0.25 and 1.55±0.28 respectively at the time of 10 min and 60-90min vs 1.17±0.19 and 1.03±0.11 in benign group. There was a significant UR difference between two groups at the same time points and within the benign group between two time points( P <0.01),but the URs of beast cancer at two time points was not significantly different ( P >0.05). The |RI| of benign group(|-0.110±0.069|) was higher than that of breast cancer(|-0.057±0.007|). ② using the x+s of benign group UR at 60-90 min time point as diagnostic threshold,the sensitivity,specificity and accuracy was 93.8%,89.5% and 92.2%,which were higher than those of visual analysis (87.5%,73.7% and 82.3%,respectively ),whereas false positive rate and false negative rate was lower(10.5% vs 26.3%,6.3% vs 12.5%,respectively). Conlusions: 99 Tc m MIBI scintimammography is an effective method for the diagnosis of breast cancer,and semi-quantitative analysing could improve the accuracy of detecting breast cancer.

关 键 词：4乳腺肿瘤 放射性核素显像 异腈类 评价 

分 类 号：R738.10[医药卫生—肿瘤]