【摘要】 目的评价⁹⁹Tc^m-奥曲肽显像在淋巴瘤中的临床应用价值。方法 11名健康志愿者和30例淋巴瘤患者进行⁹⁹Tc^m-奥曲肽显像。所有患者均进行了体格检查,胸部和腹、盆部 CT,颈部和腹股沟 B 超检查,部分完成了腹、盆腔 B 超检查（11例）,⁶⁷Ga-枸橼酸盐全身显像（5例）和骨髓检查（8例）。结果在志愿者中,⁹⁹Tc^m-奥曲肽可使脑垂体、鼻咽部、甲状腺、肝、脾、双肾、膀胱、胆囊、消化道等组织器官显影,骨骼和骨髓区内放射性分布明显低下或缺损。在30例患者中,⁹⁹Tc^m-奥曲肽显像发现22例阳性,其中2例为淋巴结炎性反应性增生疾病。其诊断患者的灵敏度和特异性分别为83.3%（20/24）和4/6,假阴性率为16.7%（4/24）;诊断病灶的灵敏度为49.3%（72/146）;对膈肌上区和膈肌下区淋巴瘤病灶的诊断灵敏度分别为51.6%（48/93）和45.3%（24/53）。显像发现4个假阳性病灶,对病灶的诊断特异性为99.6%（990/994）。结论 ⁹⁹Tc^m-奥曲肽显像探测淋巴瘤病灶的灵敏度较低;其无法对恶性淋巴瘤和淋巴结炎性反应性增生进行鉴别。更多还原

【Abstract】 Objective The aim of the study was to evaluate the role of ⁹⁹Tc^m-octreotide scintigra- phy in malignant lymphoma.Methods The subjects of the study consisted of 11 healthy adults,6 Hodgkin lymphomas（HL）,16 non-Hodgkin lymphomas（NHL）,2 recurrent NHL,4 post-treatment NHL and 2 in- flammatory reactive proliferations.After fasting over 12 h,the subjects received 555～740 MBq ⁹⁹Tc^m-oct- reotide intravenously,followed by a whole-body scan at 3～4 h post-injection.Additioual planar or tomo- graphic imaging over neck/thorax and abdomen/pelvis were undertaken if necessary.Results In healthy subjects,the radioactivity was noted in pituitary gland,nasopharynx,thyroid glands,liver,spleen,kid- neys,urinary bladder,gallbladder and gastrointestinal tract.Positive uptake of ⁹⁹Tc^m-octreotide was found in 20/24 newly diagnosed lymphoma and 2 cases of inflammatory reactive proliferations.The diagnostic sen- sitivity of detecting lymphoma patients was 83.3%（20/24）.The false negative rate was 16.7%（4/24）.The sensitivity for overall focal lesions,supradiaphragmatic lesions and infradiaphragmatic lesions were 49.3% （72/146）,51.6%（48/93）and 45.3%（24/53）,respectively.The specificity for detect patients was 4/6 and for detecting lesions was 99.6%（990/994）.Four lesions on scintigraphic scan were proved to be false positive.Conclusion With a limited sensitivity,⁹⁹Tc^m-octreotide imaging may not help in distinguishing the lymph node lesions with inflammatory process from malignant lymphoma.更多还原