【摘要】 目的评价双时相 ¹⁸F-脱氧葡萄糖（FDG）符合线路显像在肿瘤良恶性鉴别诊断中的应用价值。方法对100例临床拟诊为恶性肿瘤的患者,静脉注射¹⁸F-FDG 185～370 MBq 后40～65min 和100～140min,采用 Philips IREX 三探头符合线路 SPECT 仪分别行早期和延迟显像。测定2次显像病灶（L）和对侧正常组织（B）的感兴趣区（ROI）放射性计数,并计算 L/B 比值和 L/B 变化率（△L/B）。结果最后经病理检查或临床随访证实恶性肿瘤75例,良性病变25例。恶性肿瘤组早期显像 L/B 比值为3.62±2.07,延迟显像为5.67±3.20,△L/B 为（57.59±31.91）%;良性病生组2次显像的 L/B 比值分別为2.47±1.53（早期）和2.72±1.93（延迟）,△L/B 为（7.23±23.14）%。以△L/B>30%作为良恶性病变鉴别诊断的阈值,灵敏度为97.3%,特异性为92.0%,准确性为96.0%。结论恶性肿瘤延迟显像 L/B 比值的增高幅度明显大于良性病变,且双时相符合线路显像方法简便、实用,能提高¹⁸F-FDG 符合线路显像鉴別良恶性病变的灵敏度、特异性和准确性,有较高的临床应用价值。更多还原

【Abstract】 Objective To evaluate the usefulness of dual phase ¹⁸F-fluorodeoxyglncose （FDG） molecular coincidence detection （MCD） SPECT imaging in differentiation of malignant from benign lesions. Methods One hundred patients,including proved 75 malignant and 25 benign patients underwent coinci- dence SPECT imaging at 2 time phase:early image at 40～65 min and delay image at 100～140 rain after the intravenous injection of 185～370 MBq ¹⁸F-FDG,All imaging was performed on a Philips triple head SPECT with MCD.Region of interest （ROI） was drawn over the lesions （L） and contralateral normal tissue （B） on the coronal view,and then L/B valne change rate（Δ/B） was calcnlated for both images.Results The average L/B values of early and delay images in malignant tremors were 3.62±2.07 and 5.67±3.20 respectively with ΔL/B value （57.59±31.91）%.In contrast,values for the benign lesions were 2.47± 1.53 anti 2.72±1.93 respectively with ΔL/B （7.23±23.14）%.If taking ΔL/B value 30% as the threshold for malignancy,the sensitivity,specificity and accuracy were 97.3%,92.0% and 96.0%,respec- tively.Conclusions Malignant tumor has a greater rise of L/B value in both delay and early images.Dual phase MCD SPECT imaging is a simple,practical modality and it can improve the sensitivity,specificity and aecturacy for detection of malignant tumor.更多还原