CAJ | 학술논문

目的评价同机图像融合技术99mTc-MIBI显像对肺部恶性肿瘤的诊断价值.方法临床经X线平片或CT扫描发现肺部结节患者34例,共计48个肺部结节样病灶,以GE公司InfiniaHawkeye 4 SPECT-CT行10min及2h延迟胸部断层99mTc-MIBI显像,以ROI技术测定其T/NT比值,并以同机螺旋CT扫描同机图像融合,对早期及延迟图像分别读片,判断显影结果,并对其T/NT比值根据其最终病理结果进行统计分析.结果 34例患者共计48个肺部结节,早期显像阳性结节数21,延迟显像阳性结节数16,(T/NT比值＞3.33),以延迟显像阳性为最终判定标准,肺部恶性病灶其T/NT比值较良性病灶差异有统计学意义(P＜0.05).阴性结节数为27,经手术病检证实13例为肺部恶性肿瘤病灶,假阳性结节数3,假阴性结节数为2,其灵敏度88.88%,特异性90.9%,阳性预测值+PV 84.21%,阴性预测值-PV 93.75%.结论 99mTc-MIBI作为一种肿瘤阳性显像剂,对于肺部占位性病变的灵敏度高,但其特异性不高,而99mTc-MIBI显像和CT扫描,其可提高其诊断价值,与普通SPECT显像相比,灵敏度及特异性均有显著提高.可在不具备PET-CT及符合探测SPECT设备的基层医院及经济欠发达地区运用.
목적 평개동궤도상융합기술99mTc-MIBI현상대폐부악성종류적진단개치.방법 림상경X선평편혹CT소묘발현폐부결절환자34례,공계48개폐부결절양병조,이GE공사InfiniaHawkeye 4 SPECT-CT행10min급2h연지흉부단층99mTc-MIBI현상,이ROI기술측정기T/NT비치,병이동궤라선CT소묘동궤도상융합,대조기급연지도상분별독편,판단현영결과,병대기T/NT비치근거기최종병리결과진행통계분석.결과 34례환자공계48개폐부결절,조기현상양성결절수21,연지현상양성결절수16,(T/NT비치＞3.33),이연지현상양성위최종판정표준,폐부악성병조기T/NT비치교량성병조차이유통계학의의(P＜0.05).음성결절수위27,경수술병검증실13례위폐부악성종류병조,가양성결절수3,가음성결절수위2,기령민도88.88%,특이성90.9%,양성예측치+PV 84.21%,음성예측치-PV 93.75%.결론 99mTc-MIBI작위일충종류양성현상제,대우폐부점위성병변적령민도고,단기특이성불고,이99mTc-MIBI현상화CT소묘,기가제고기진단개치,여보통SPECT현상상비,령민도급특이성균유현저제고.가재불구비PET-CT급부합탐측SPECT설비적기층의원급경제흠발체지구운용.
Objective To evaluate the value of the fusion of 99m Tc-MIBI imaging technology apply in the diagnosis of malignant lung tumor. Methods Thirty - four cases with lung nodules proved by X-ray and/or CT scanning, a total of 48 lung nodular lesions. And the imaging with-99m Tc-MIBI of chest performed at 10 minutes and 2 hours delayed after injection by GE Infinia Hawkeye 4 SPECT-CT. then the regions of interesting ( ROI) were drawn in the tumor and contra lateral position to calculate the radioactivity ratios of tumor to normal ( T/NT) , and fused with the spiral CT scanning image in the same machine, and reading the early and delayed image respectively. Judged the result of the image develops, and statistical analysis of the ratio (T/NT) according to the final pathologic consequence. Results All cases with total of 48 nodular lesions, 21 nodules were positive in early imaging, 16 nodules were positive in delayed imaging (the ratio T/NT over 3. 33). defined the delayed image positive as the final criterion, The(T/NT)ratios of Malignant lung lesions were significantly higher than the benign lesions ( P ＜0. 05). Negative nodes 27, 13 cases of lung cancer lesions were malignant, confirmed by postoperative pathologic examination. The falsepositive nodules 3, false-negative nodules 2. The sensitivity was: 88.88%, the specificity was: 90.9% positive predictive value ( +PV) was: 84. 21% , negative predictive value (-PV) is: 93.75%. Conclusion 99mTc-MIBI as a tumor positive imaging agent is highly sensitivity to lung lesions, but specificity is not so high.