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目的:观察~(99m)Tc-MIBI及~(99m)Tc-GH联合三维立体显像对肺癌患者的临床应用价值。方法:对48例肺占位病变的患者,采用PHILIPS公司FORTE-AZ SPECT仪进行采集,配以低能高分辨准直器,均分别行~(99m)Tc-MIBI及~(99m)Tc-GH早期和延迟肺显像。断层采集矩阵64×64,每帧40s,zoom1.5,采集64帧,获得三维影像并进行三维动态显示;同时,测定病变靶/非靶摄取比值和肿瘤滞留指数。结果:研究结果表明,三维显示对诊断肺部恶性病变优于平面显像法,~(99m)Tc-MIBI显像的灵敏度89.5%,特异性90.0%,准确率89.6%;~(99m)Tc-GH显像灵敏度86.8%,特异性80.0%,准确率85.4%;两种显像方法具有互补性。肺良性病变患者早期及延迟显像的病变靶/非靶摄取比值分别≤1.14±0.02和1.06±0.13,肿瘤滞留指数<0;肺癌患者分别≥1.36±0.09和1.39±0.14,肿瘤滞留指数>1。肺癌化、放疗后早期显像和延迟显像的病变靶/非靶摄取比值和肿瘤滞留指数均明显低于治疗前的相应值。结论:~(99m)Tc-MIBI三维立体显像法可提高肺癌阳性显像的分辨力,更好地进行空间定位,提高肺癌原发病灶及其在相邻的部位转移灶检出率,是一项实用性较强的肺癌辅助检查手段。同时也是监测肺癌复发与评价肺癌治疗效果的有效方法。
Objective: To observe the clinical value of ~ (99m) Tc-MIBI and ~ (99m) Tc-GH combined with three-dimensional imaging in patients with lung cancer. Methods: Forty-eight patients with lung lesions were collected by PHILIPS FORTE-AZ SPECT instrument and equipped with low-energy and high-resolution collimators. The 99m Tc-MIBI and 99m Tc-GH Early and delayed lung imaging. The tomographic acquisition matrix 64 × 64, each frame 40s, zoom1.5, collecting 64 frames, to obtain three-dimensional images and three-dimensional dynamic display; the same time, the lesion target / non-target uptake ratio and tumor retention index. Results: The results showed that the sensitivity and accuracy of three-dimensional display in diagnosing pulmonary malignant lesions were 89.5%, 90.0% and 89.6%, respectively; 99m Tc-MIBI 99m Tc- -GH imaging sensitivity of 86.8%, specificity 80.0%, accuracy 85.4%; two imaging methods are complementary. The ratio of target lesion to non-target uptake in early stage and delayed stage of lung benign lesion were ≤1.14 ± 0.02 and 1.06 ± 0.13, respectively. The tumor retention index was less than 0.36, the positive rate of tumor retention was> 1.36 ± 0.09 and 1.39 ± 0.14 respectively, and the tumor retention index was> 1 . Lung cancer, early post-radiotherapy and delayed imaging of the target lesion / non-target uptake ratio and tumor retention index were significantly lower than the corresponding value before treatment. CONCLUSION: ~ (99m) Tc-MIBI three-dimensional imaging can improve the resolution of lung cancer positive imaging, make better spatial location and improve the detection rate of primary lung cancer and its adjacent metastases A practical method of lung cancer aids. It is also an effective method to monitor the recurrence of lung cancer and evaluate the therapeutic effect of lung cancer.