99tcmmibi双时相显像在四肢骨肿瘤诊疗中的临床应用价值 word格式.docxVIP

99Tcm-MIBI 双时相显像在四肢骨肿瘤诊疗中的 临床应用价值研究生：郭勇导师：秦永德 教授摘要目的：探讨 99Tcm-甲氧基异丁基异腈（MIBI）双时相显像对四肢骨肿瘤的诊断 价值及在恶性肿瘤疗效评估中的作用并与 99Tcm-亚甲基二膦酸盐（MDP）骨三相显 像结果进行比较。方法：71 例四肢骨占位患者，经病理或影像学证实的恶性肿瘤 52 例，良性病变 19 例，均分别行 99Tcm-MDP 骨三相、SPECT/CT 融合显像及99Tcm-MIBI 双时相检查，进行视觉读片及半定量分析，数据结果与金标准病理结果 对照并行统计学处理，用受试者工作特征曲线（ROC）分析法评价 99Tcm-MIBI 双时 相显像对四肢骨肿瘤的诊断效能。采用 99Tcm-MIBI 双时相结果半定量计算滞留指数（RI），与随访结果进行对照分析。结果：71 例四肢骨病变中 99Tcm-MDP 骨三相显 像的灵敏度最高（94.2%），99Tcm-MIBI 亲肿瘤的特异性最高（84.2%），骨三相结果 与 99Tcm-MIBI 亲肿瘤早期显像结果具有较高的一致性（73.2%），99Tcm-MIBI 早期显 像中恶性病灶部位与对侧正常组织放射性计数比值（T/N）（2.46±0.92）明显高于良 性病灶（1.79±1.03），差异有统计学意义（P＜0.01），ROC 得出的诊断 T/N 比值区 间：1.60-2.36(最佳取值点 1.795)；恶性病例中有 19 例复发患者，RI 为-0.6~0，33 例未复发患者 RI 为-0.3~1.2。结论：99Tcm-MIBI 对骨结节有较好地诊断价值，在良 恶性骨肿瘤定性方面可增加诊断信息，在化疗疗效评估方面，双时相 RI 可以在化疗 前预测疗效方面发挥一定的作用。关键词：骨肿瘤；功能影像；99Tcm-甲氧基异丁基异腈； 发射型计算机断层；单光子The diagnostic value of 99Tcm-MIBI double phase imaging in malignant and benign bone lesions of appendicular skeletonPostgraduate：Guo YongTutor：Prof.Qin YongdeAbstractObjective: To investigate the diagnostic value of the 99mTc-MIBI double phase imaging in differentiate malignant and benign bone lesions of appendicular skeleton and in the assessment of tumor response to chemotherapy. Methods: 71 patients (52 malignant cases, 19 benign cases) studied with both imaging agents Planar, 99Tcm-MIBI double phase imaging was performed 30 min and 120min after injection of 740 MBq Within 3 days, 99Tcm-MDP three phase were tested, Using ROC curve evaluation of the diagnostic performance that 99Tcm-MIBI to bone tumors. Results: With 71 cases of appendicular skeleton lesions bone three-phase imaging sensitivity was highest (94.2%), but the specificity of 99Tcm-MIBI early imaging was highest (84.2%), bone three-phaseresults and 99Tcm-MIBI tumor early imaging result has high consistency (73.3%). Inquantitative analysis of 99Tcm-MIBI early scan, the mean T /N ratio of malignant lesions (2.46±0.92) was significantly higher than that of benign counterparts (1.79±1.03, P＜ 0.01), the region of malignant