【摘要】 目的探讨99Tcm生长抑素受体(99Tcm奥曲肽)显像对肺部肿瘤的诊断价值。方法56例胸部CT检查疑诊为肺癌的患者,行99Tcm奥曲肽显像检查,其中23例行氟脱氧葡萄糖F18(18F FDG)双探头符合线路显像(DHC),并将影像学结果与病理检查结果进行对比分析。结果病理检查证实,56例患者中,肺癌46例,肺良性病变10例。99Tcm奥曲肽显像:53例结果与病理结果相同(44例肺癌、9例肺良性病变);2例病理检查为肺腺癌,99Tcm奥曲肽显像为肺良性病变,1例病理证实为肺结核球,99Tcm奥曲肽显像为肺癌。18F FDGDHC:19例结果与病理结果相同(13例肺癌、6例肺良性病变);4例病理证实为肺良性病变,18F FDGDHC检查为肺癌。以病理结果为诊断标准,99Tcm奥曲肽显像诊断肺癌的敏感性、特异性和准确性分别为95.7%、90.0%和94.6%,阳性预测值(PPR)为97.8%,阴性预测值(NPR)为81.8%;18F FDGDHC诊断肺癌的敏感性、特异性、准确性分别为100%、60.0%、82.6%,PPR为76.5%,NPR为100%。18F FDGDHC诊断为肺癌的13例患者,6例有淋巴结转移,18F FDGDHC共检出10枚转移淋巴结,99Tcm奥曲肽显像仅检出2枚。2例肺癌脑转移,两种显像方法均清晰显示脑部转移灶。结论99Tcm奥曲肽显像是一种无创、安全、经济的检查方法,对肺癌原发病灶有较好的诊断价值,但对淋巴结转移诊断价值?更多还原

【Abstract】 Objective To evaluate the clinical value of 99Tc m -sandostatin receptors imaging ( 99Tc m -sandostatin )in detection of lung tumors in comparison with fludeoxyglucose F18 dual head coincidence imaging ( 18F-FDG DHC). Methods Fifty-six consecutive patients(40 men ,16 women; mean age: 62 years,range 35-80 years) with pulmonary neoplasm were referred for evaluation . All underwent sandostatin scintigraphy using hybrid SPECT/CT. 18F-FDG DHC imaging was also performed in 23 patients using the same camera. The tumor uptake of 99Tc m -sandostatin and 18F-FDG DHC were measured respectively and expressed as the ratio of T/Nr and T/Nm. Final clinical diagnosis was confirmed by histopathological study. Results Out of 56 cases, 46 were confirmed to be malignant and 10 benign. The sensitivity, specificity and accuracy of 99Tc m -sandostatin in diagnosis of lung cancer were 95.7%, 90.0%, 94.6%, respectively. The positive predictive value(PPR) was 97.8%, and the negative predictive value (NPR)was 81.8%. In the 23 patients underwent both methods, the sensitivity , specificity and accuracy of 18F-FDG DHC were 100%, 60.0%, 82.6%,respectively; the PPR was 76.5%, and the NPR 100%. Out of 13 patients with malignant neoplasms, 6 patients had regional lymph node metastasis, and all of 10 abnormal lymph nodules showed high uptake of FDG, while 99Tc m-sandostatin imaging only 2 regional metastatited lymph nodes in one patient. T/N_r and T/N_m were 3.15±1.30,and 10.61±4.35 respectively. There was no relationship between sandostatin uptake and glucose metabolism. Conclusion 99Tc m - sandostatin scintigraphy is a promising noninvasive imaging technique for detection of the primary tumor of lung cancer but of limited value in the detection of lymph node metastasis.更多还原