CAJ | 학술논문

目的利用99Tcm体内标记RBC法,探讨Hawkeye VG型SPECT/CT融合显像在下消化道出血定位诊断中的临床应用价值.方法回顾性分析56例确诊下消化道出血的患者资料,其中男42例,女14例,年龄10～ 76岁.采用体内标记法标记RBC,剖腹探查术前静脉注射99TcmO4-洗脱液370 MBq后即刻行下腹部平面显像,随后在同一床位行SPECT和CT扫描,并进行图像融合处理.分析图像,进行下消化道出血的定位诊断.x2检验分析平面显像与SPECT/CT融合显像的诊断灵敏度与定位准确性间的差异.结果 56例患者中,平面显像和融合显像示下腹部有放射性异常浓聚灶者分别为50例和52例.2种显像方法各有42例和52例完成出血定位诊断,其中平面显像有31例,融合显像有48例定位与手术探查出血点一致.2种显像方法诊断灵敏度分别为89.3％(50/56)和92.9％ (52/56),差异无统计学意义(x2=0.11,P＞0.05)；定位准确性分别为73.8％ (31/42)和92.3％ (48/52),两者差异有统计学意义(x2=4.63,P＜0.05).结论 Hawkeye VG型SPECT/CT融合显像是一种灵敏、简便、准确的下消化道出血定位检查方法.
목적 이용99Tcm체내표기RBC법,탐토Hawkeye VG형SPECT/CT융합현상재하소화도출혈정위진단중적림상응용개치.방법 회고성분석56례학진하소화도출혈적환자자료,기중남42례,녀14례,년령10～ 76세.채용체내표기법표기RBC,부복탐사술전정맥주사99TcmO4-세탈액370 MBq후즉각행하복부평면현상,수후재동일상위행SPECT화CT소묘,병진행도상융합처리.분석도상,진행하소화도출혈적정위진단.x2검험분석평면현상여SPECT/CT융합현상적진단령민도여정위준학성간적차이.결과 56례환자중,평면현상화융합현상시하복부유방사성이상농취조자분별위50례화52례.2충현상방법각유42례화52례완성출혈정위진단,기중평면현상유31례,융합현상유48례정위여수술탐사출혈점일치.2충현상방법진단령민도분별위89.3％(50/56)화92.9％ (52/56),차이무통계학의의(x2=0.11,P＞0.05)；정위준학성분별위73.8％ (31/42)화92.3％ (48/52),량자차이유통계학의의(x2=4.63,P＜0.05).결론 Hawkeye VG형SPECT/CT융합현상시일충령민、간편、준학적하소화도출혈정위검사방법.
Objective To evaluate the clinical application of Hawkeye VG SPECT/CT imaging on diagnosing and locating lower gastrointestinal bleeding using in vivo labeling 99Tcm-RBC.Methods Fiftysix patients (42 males,14 females,age ranging from 10 to 76 years) who had definite lower gastrointestinal bleeding were studied retrospectively.All patients had intravenous injection with 370 MBq 99Tcm-RBC and then underwent planar,SPECT,and CT imaging respectively in the abdomen before exploratory laparotomy.Images from SPECT and CT were fused thereafter to locate the active bleeder,if any.x2 test was performed to show the differences of diagnostic sensitivity and accuracy between planar and SPECT/CT imaging.Results In 56 patients with lower gastrointestinal bleeding,50 patients showed abnormally concentrated radionuclide activity with planar images and 52 patients showed the similar imaging pattern with SPECT/CT.Among these patients,concordant bleeding with operation findings was found in 31 patients with planar images and 48 patients with SPECT/CT images.The sensitivity and accuracy were 89.3％ (50/56) and 73.8％ (31/42) in planar images,and 92.9％ (52/56) and 92.3％ (48/52) in SPECT/CT images (x2 =0.11,P＞0.05 ;x2 =4.63,P＜0.05).Conclusion Hawkeye VG SPECT/CT imaging shows an effective,simple and accurate method and could be used for diagnosing and locating lower gastrointestinal bleeding.