【摘要】 目的探讨氧介入99mTc-MIBI SPECT/CT同机融合鉴别诊断孤立性肺结节(SPN)的价值。方法收集34例SPN患者,令其于注射99mTc-MIBI前吸氧。分别于注射99mTc-MIBI后10min、2h进行早期和延迟SPECT/CT断层同机融合显像,分析良、恶性SPN早期摄取比值(EUR)和延迟摄取比值(DUR),并对其诊断效率进行ROC曲线分析。结果 34例SPN患者中,10例为原发性肺癌;24例良性肺部病变。氧介入99mTc-MIBI SPECT/CT同机融合显像定性分析鉴别诊断良、恶性SPN的敏感度为90.00%(9/10),特异度为87.50%(21/24),准确率为88.24%(30/34),阳性预测值为75.00%(9/12),阴性预测值为95.45%(21/22)。恶性SPN的EUR为2.13±0.62(95%CI 1.68～2.57),良性SPN为1.31±0.42(95%CI 1.13～1.48);恶性SPN的DUR为2.40±0.47(95%CI 2.07～2.74),良性SPN为1.37±0.64(95%CI 1.09～1.64)。恶性肺部病灶EUR和DUR均显著高于良性肺部病灶(t=4.53、4.59,P均<0.001)。半定量ROC分析显示,以EUR≥1.50为界值,敏感度90.00%,特异度79.20%;以DUR≥1.47为界值,敏感度100%,特异度79.20%。结论氧介入99mTc-MIBI SPECT/CT同机融合显像对鉴别良、恶性SPN具有较高的临床价值。更多还原

【Abstract】 Objective To explore the differential diagnostic value of 99mTc-MIBI SPECT/CT fusion imaging combined with oxygen intervention for solitary pulmonary nodule(SPN).Methods Thirty-four patients with SPN were enrolled.All patients absorbed oxygen before 99mTc-MIBI injection.The early and delayed SPECT/CT fusion imaging of the chest were performed 10 min and 2 h after 99mTc-MIBI injection,respectively.The early and delayed uptake ratios(EUR and DUR) of benign and malignant SPN were compared.The efficiency of EUR and DUR in diagnosing SPN were analyzed with ROC curve.Results There were 10 patients with malignant SPN and 24 patients with benign SPN.The sensitivity,specificity,accuracy rate,positive predictive value and negative predictive value of qualitative analysis was 90.00%(9/10),87.50%(21/24),88.24%(30/34),75.00%(9/12) and 95.45%(21/22),respectively.In patients with malignant SPN,EUR was 2.13±0.62(95%CI 1.68—2.57),whereas that in patients with benign SPN was 1.31±0.42(95%CI 1.13—1.48).In patients with malignant SPN,DUR was 2.40±0.47(95%CI 2.07—2.74),whereas that in patients with benign SPN was 1.37±0.64(95%CI 1.09—1.64).EUR and DUR were significantly different between malignant and benign SPN(t=4.53,4.59;both P<0.001).Semiquantitative analysis showed that when EUR≥1.50,the value of sensitivity and specificity was 90.00% and 79.20%,for DUR ≥1.47,the value of sensitivity and specificity was 100% and 79.20%,respectively.Conclusion 99mTc-MIBI SPECT/CT fusion imaging combined with oxygen intervention has good clinical value in differential diagnosis of malignant and benign SPN.更多还原