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目的:探讨乳突区皮下注射99m锝右旋糖酐(99mTcDX105)单光子发射计算机断层扫描(SPECT)颈淋巴显像对喉癌和下咽癌颈淋巴结转移的诊断价值。方法:对30例喉癌和下咽癌患者术前经双侧乳突区皮下注射99mTcDX105SPECT颈淋巴显像与颈廓清标本病理检查进行对比研究。结果:30例患者53侧颈部SPECT,显像阳性24侧,其中3侧为假阳性;阴性29侧,其中1侧为假阴性。53侧SPECT颈淋巴显像的敏感性、特异性及准确率分别为95.5%(21/22)、90.3%(28/31)和92.5%(49/53)。8侧隐匿性转移淋巴结中SPECT显像检出7侧,检出率为87.5%(7/8)。结论:乳突区皮下注射99mTcDX105SPECT颈淋巴显像对指导喉癌和下咽癌的临床分期及颈淋巴结清扫,具有一定的临床意义。
Objective: To investigate the diagnostic value of 99mTcDX105 single photon emission computed tomography (SPECT) cervical lymphoscintigraphy in diagnosis of cervical lymph node metastasis of laryngeal and hypopharyngeal carcinoma subcutaneously in mastoid region. Methods: Thirty patients with laryngeal and hypopharyngeal carcinoma underwent subcutaneous injection of 99mTcDX105SPECT cervical lymphadenectomy and neck dissection on the pathological examination before operation. Results: In the 30 cases, the SPECT on 53 sides of the neck was positive in 24 sides, of which 3 sides were false positives and 29 negative sides, of which 1 was false negative. The sensitivity, specificity and accuracy of 53 SPECT neck lymphoscintigraphy were 95.5% (21/22), 90.3% (28/31) and 92.5% (49/53), respectively. Eight sides of the occult metastatic lymph nodes SPECT imaging detected 7 sides, the detection rate was 87.5% (7/8). Conclusion: The subcutaneous injection of 99mTcDX105SPECT cervical lymphoscintigraphy in the mastoid region has clinical significance in guiding the clinical stage and lymph node dissection of laryngeal and hypopharyngeal carcinoma.