^(99)Tc^m标记MIBI与MDP骨常规及延迟显像对比研究  

A Comparative Study on ^(99) Tc^m-MIBI and MDP Imaging Agents Adopted Routine and Delaied Bone Scan in Diagnosis of Bone Lesions

作　　者：彭祖光[1] 周路[1] 雷伟华[2] 李永明[1] 龙贵珍[1] 

机构地区：[1]肇庆市第一人民医院核医学科,广东肇庆526021 [2]肇庆市第一人民医院病理科,广东肇庆526021

出　　处：《广州医学院学报》2003年第1期41-45,共5页Academic Journal of Guangzhou Medical College

摘　　要：目的 :探讨99Tcm MIBI与99Tcm MDP骨常规及其延迟显像对骨良恶性病变的诊断、鉴别诊断及疗效评估的临床应用价值及影响因素。方法 :6 8例临床拟诊骨病变患者分别进行99Tcm MDP和99Tcm MIBI骨显像 ;MIBI呈阳性者均行延迟显像 ;最终均行手术治疗及病理检查 ;其中 12例于术前曾行化疗和 /或放疗 ,治疗前后均行上述 2项显像。结果 :①99Tcm MIBI显像 :76 .3% (6 1/ 80病灶 )恶性肿瘤病灶肉眼可见中、高度MIBI浓聚 ;而良性病灶仅有 2 7.3% (6 /2 2 )的轻、中度浓聚 ;恶性病灶与对侧正常组织计数比值 (L/C)为 3.16± 1.36明显高于良性病灶 (1.35± 0 .5 6 ) ,P <0 .0 1;延迟显像有利于良性病灶假阳性的鉴别。②99Tcm MDP显像 :上述所有病灶均肉眼可见MDP浓聚 ,但恶性病灶L/C(3.6 6± 1.2 7)与良性病灶L/C(2 .97± 1.0 3)比较差异无显著性 (P >0 .0 5 )。③化疗及放疗可以较明显抑制99Tcm MIBI摄取 (但放疗却可增加99Tcm MDP摄取 ) ,因此99Tcm MIBI摄取程度与99Tcm MDP比较能较好反应治疗效果。结论 99Tcm MIBI骨常规及延迟显像对鉴别诊断良恶性骨病和评估疗效有较好的应用价值 ,若与99Tcm MDP显像联合应用可提供更多有价值的信息。Objective:To assess the use and the relevant factors of routine and delayed bone scan with 99 Tc m MIBI and 99 Tc m MDP in diagnosis and differentiative diagnosis of malignant and benign bone lesions and in the assessment of tumor response to chemotherapy and radiotherapy Methods 68 patients with various bone pathological changes (49 malignant and 19 benign lesions) were studied with both imaging agents. The planar 99 Tc m MDP local and whole body bone scan were performed 3～4h after injection of 740MBq of 99 Tc m MDP. Within 3 days after 99 Tc m MDP study,the planar 99 Tc m MIBI scintigraphy was done 30～60min after injection of 740MBq of 99 Tc m MIBI,respectively. At the same time,the delaied scan was performed after positive reaction in 99 Tc m MIBI scintigraphy. Results With 99 Tc m MIBI imaging,most malignant focuses (76.3%) clearly showed medium high radioactivity accumulation. Most benign focuses (72.7%) had not obviously visible uptake of 99 Tc m MIBI. In quantitative analysis,the mean lesion/contralateral (L/C) ratio of malignant lesions (3.16±1.36) was significantly higher than that of benign lesions (1.35±0.56, P <0.01). The delaied scan had positive effect in differentiative diagnosis of benign lesions with phony positive reaction. About 99 Tc m MDP bone scan: All of malignant and benign lesions showed visible uptake of 99 Tc m MDP,but L/C (3.66±1.27) of malignant focuses versus that of benign focuses (2.97±1.03) was of no significantly difference ( P >0.05). 21 cases with malignant tumor underwent both pre and post therapy 99 Tc m MIBI and 99 Tc m MDP evaluation,respectively. It was demonstrated that chemotherapy was able to inhibit MIBI uptake. Conclusion 99 Tc m MIBI imaging gave a good reflection of the effectiveness of therapy. Combined application of two imaging agents was able to provide more clinical value in differentiative diagnosis and in evaluation of the therapy of m

关 键 词：骨肿瘤 核素显像 MIBI MDP 

分 类 号：R814[医药卫生—影像医学与核医学]