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目的 探讨99Tcm sandostatin生长抑素受体显像对肺癌的诊断价值。方法 35例肺部肿瘤患者静脉注射99Tcm sandostatin (991 6± 187 5 9)MBq后行平面及胸部断层SPECT显像 ,重建后获得发射 透射图像及融合图像。勾画感兴趣区 ,计算肿瘤和对侧正常肺组织的放射性比值 (T N)。所有病灶均经病理检查及 (或 )其他检查证实。 5例孤立性肺结节 (SPN)行1 8F 脱氧葡萄糖 (FDG)符合线路显像 ,1例小细胞肺癌 (SCLC)治疗前后均行99Tcm sandostatin显像。 15例受检者于99Tcm sandostatin显像后 1周内行全身骨显像。结果 99Tcm sandostatin显像诊断肺癌的灵敏度、特异性和准确性分别为 93 3%、5 5例和 94 3%。 2例鳞癌99Tcm sandostatin显像假阴性。 4例SCLC99Tcm sandostatin显像发现胸膜异常放射性浓聚区 ,病理检查证实为胸膜转移。15例骨显像中 12例发现骨转移 ,99Tcm san dostatin仅发现 5例骨转移。SCLC、非小细胞肺癌 (NSCLC)T N分别为 3 4 3± 0 6 6、2 2 4± 0 31,差异有显著性 (t=4 0 72 ,P <0 0 0 1)。SCLC对99Tcm sandostatin的摄取明显高于NSCLC。结论 99Tcm san dostatin生长抑素受体显像无创、安全、经济 ,对肺癌有较好的诊断价值。
Objective To investigate the diagnostic value of 99Tcm sandostatin somatostatin receptor imaging in lung cancer. Methods Thirty-five patients with pulmonary tumors underwent 99Tcm sandostatin (991 6 ± 187 5 9) MBq intravenously and were examined by planar and thoracic SPECT. The images were reconstructed to obtain transmission and fusion images. Regions of interest were delineated to calculate the radioactivity ratio (T N) between the tumor and the contralateral normal lung tissue. All lesions were confirmed by pathology and / or other tests. Five cases of solitary pulmonary nodules (SPN) underwent 18 F-FDG imaging and 99 Tcm sandostatin imaging was performed on one small cell lung cancer (SCLC) before and after treatment. Fifteen subjects underwent total body scintigraphy within 1 week after 99Tcm sandostatin imaging. Results The sensitivity, specificity and accuracy of 99Tcm sandostatin imaging in the diagnosis of lung cancer were 93.3%, 55 and 94.3%, respectively. Two cases of squamous cell carcinoma 99Tcm sandostatin imaging negative. 4 cases of SCLC99Tcm sandostatin imaging found abnormal pleural effusion concentration, pathological examination confirmed pleural metastasis. Bone metastases were found in 12 of 15 bone scintigraphy and 5 of 99 Tcm san dostatin. The T N of SCLC and non-small cell lung cancer (NSCLC) were 34 ± 0 6 6 and 22 4 ± 0 31, respectively, with significant difference (t = 4 0 72, P 0 01 0). The uptake of 99Tcm sandostatin by SCLC was significantly higher than that of NSCLC. Conclusion 99Tcm san dostatin somatostatin receptor imaging noninvasive, safe and economical, and has a good diagnostic value for lung cancer.