~(99m)TcMIBI乳腺显像对乳腺肿物良恶性及淋巴结转移的诊断价值

目的 :探讨99mTc MIBI乳腺显像对乳腺癌及淋巴结转移的诊断价值。方法 :6 8例单侧乳腺肿物的女性患者 ,从病变乳腺对侧的肘静脉注入99mTc MIBI 740MBq ,10min后分别行前位、侧位乳腺显像。结果 :6 8例乳腺肿物患者 ,经病理证实恶性 38例 ,良性 30例。99mTc MIBI乳腺显像阳性共 37例 ,其中乳腺癌 34例 ,乳腺良性肿瘤 3例。99mTc MIBI乳腺显像诊断乳腺癌的灵敏性为 89 5 % ,特异性为 90 % ,阳性预测值为 91 9% ,阴性预测值为87 1% ;38例乳腺癌患者 8例淋巴结转移 ,6例99mTc MIBI显像阳性。结论 :99mTc MIBI乳腺显像可成为诊断乳腺癌及鉴别乳腺肿物良恶性较可靠的无创性方法 ,其对淋巴结转移的检测也有一定价值     

~(99m)TC-tetrofosmin显像诊断乳癌及腋淋巴结转移的临床价值

目的　评估99mTC tetrofosmin显像诊断乳腺癌和腋淋巴结转移癌的临床价值。方法　对 5 2例乳腺肿块病人进行99mTC tetrofosmin显像。全部患者均在 2周内行外科手术治疗 ,并作病理诊断对照。结果　 2 6例患者被病理证实患有乳腺癌。 3 0例为良性病变。99mTC tetrofosmin显像发现了乳癌中的 2 1例 ,以及 16例合并有腋窝淋巴结转移癌中的 11例。99mTC tetrofosmin显像对乳癌诊断的敏感性、特异度和准确率分别是 80 .8%、76.7%、78.6%。诊断腋淋巴结转移的敏感性、特异度和准确率分别是 68.8%、80 .0 %、76.0 %。结论　99mTC tetrofosmin显像鉴别乳腺肿物良恶性和腋淋巴结转移均有临床意义。     

乳腺肿物异常摄取99Tc—MDP的84例临床分析

目的：探讨99mTc—MDP全身骨显像时乳腺肿物摄取显像剂显影的临床意义。方法：84例乳腺肿物患者静脉注射99mTc—MDP后2—3小时行全身骨显像,乳腺出现局灶性或弥漫性99mTc—MDP放射性浓聚为异常,所有肿物均经手术及病理证实。结果：84例全身骨显像患者中69例乳腺肿物局灶性摄取99mTc—MDP,其中62例为恶性;15例乳腺弥漫性摄取者中3例为恶性。结论：99mTc—MDP全身骨显像乳腺肿物异常显影对乳腺肿物良恶性的鉴别有一定的价值。     

盆腔、超声检查和CA125测定鉴别卵巢良恶性包块分析

[目的]研究盆腔检查(PE)、超声检查(US)及血清CA125水平在鉴别卵巢良恶性包块方面的作用及3项检查联合应用的价值。[方法]对拟手术治疗的卵巢包块患者在术前均行PE ,US及血清CA125测定。[结果]绝经前妇女中8 5 %(11/130)为卵巢恶性肿瘤 ,绝经后妇女中36 3 %(29/80)为卵巢恶性肿瘤 ,PE的敏感性、特异性、阳性预测值、阴性预测值及准确性的百分率分别为62 5 %、82 4 %、45 5%、90.3 %及78 6% ;CA125的上述诊断指数分别为85 0 %、80 6 %、50 7 %、95 8%及81 4 % ;US的上述诊断指数分别为95 0%、94 1%、79 2%、98 8 %及94 3 %。在3种检查方法中 ,US的各项指数最好 ,尤其是在绝经后妇女。如果3项检查均为阴性 ,则所有患者的卵巢包块均为良性 ;如3项检查均为阳性 ,则95.2 %患者卵巢包块为恶性。[结论]PE、血清CA125测定及US在术前诊断卵巢包块良恶性方面均有一定作用 ,但是他们也都有各自的不足 ,如三者联合应用则在鉴别卵巢包块良、恶性方面具有更大价值。     

超声造影在附件区肿块良恶性鉴别诊断中的应用

目的:评价超声造影 (CEUS)在常规超声(US)不能鉴别诊断的附件区良恶性包块中的应用价值.方法:2010年8月30日至2011年1月31日间,对US未能显示出病灶特征,良恶性鉴别诊断困难的附件区包块24例患者再行CEUS.回顾性分析其临床病理资料.结果:19例经穿刺或/和外科手术病检证实、5例经临床诊断(诊断性治疗、复查和随访)证实:卵巢恶性肿瘤13例、良性包块11例(良性肿瘤9例、附件炎性包块2例).CEUS诊断13例恶性肿瘤准确率100%,敏感性100%(13/13);诊断良性包块9例正确,2例误诊(粘液性囊腺瘤诊断为粘液性囊腺癌),特异性82%(9/11);CEUS鉴别附件区良、恶性包块的准确性为92%(22/24).结论:CEUS可敏感显示US不能鉴别诊断的附件区良、恶性包块的病变特征,有助于良/恶性质的诊断与鉴别诊断.     

99m Tc-MIBI及67 Ga肺显像诊断原发性肺癌的对比研究

目的 :评价 99mTc MIBI (锝—甲氧基异丁基异腈 )及 67Ga (镓 )肺肿瘤显像诊断原发性肺癌的临床价值。方法 :对 72例肺癌患者均进行了 99mTc MIBI与 67Ga肺肿瘤显像 ,勾画病变部位 (T)及对侧正常肺组织 (N)对应部位的感兴趣区 (ROI) ,计算摄取比值 (T/N)及滞留指数RI =(延迟T/N—早期T/N)× 10 0 /早期T/N ,并取病灶部位放射性较正常肺组织摄取明显增高为阳性指标进行定性分析。结果 :99mTc MIBI及 67Ga诊断肺癌的阳性率分别为 72 .2 %、91.7% ,两者结合阳性率为 97 2 %。99mTc MIBI及 67Ga显像对纵隔淋巴结转移的阳性率分别为 85 .7%、5 0 .0 %。结论 :99mTc MIBI及 67Ga两者联合应用可提高肺癌的阳性检出率。单独使用时 ,67Ga显像在显示肺癌部位上具有优越性 ,在显示纵隔淋巴结转移灶中99mTc MIBI占优势。     

MRI多时相增强扫描对钼靶BI-RADS4级乳腺疾病的诊断价值

[目的]探讨MRI多时相增强扫描对BI-RADS4级(乳腺钼靶)病变的良恶性鉴别价值。[方法]对乳腺钼靶分级BI-RADS4级病变的80例患者行双侧乳腺平扫及多时相动态增强。通过对病灶MRI平扫及多时相增强图像进行分析判定病变良恶性。[结果]MRI诊断BI-RADS4级病变良恶性灵敏度及特异性分别为97.5%和95.0%,阳性预测值95.1%,阴性预测值97.4%。[结论]应用乳腺多时相增强MRI对于钼靶诊断为4级病变的鉴别诊断有重要作用。     

胃黏膜相关淋巴组织淋巴瘤合并乳腺叶状肿瘤一例

患者 女,49岁,2010年1月发现右乳无痛性肿块就诊,查体：右乳外上象限10点位距乳头约3 cm,可扪及5 cm×3cm×4cm包块,余无特殊.钼靶检查示：右乳占位性病变.行右乳包块切除术,术后病理示：右乳腺纤维上皮性肿瘤,部分区域细胞生长较活跃伴异型性,倾向于叶状肿瘤（图1a）.诊断：右乳腺分叶状肿瘤.此后定期复查.201 1年3月又发现右乳原发部位肿块,查体：右乳腺10点位距乳头约3 cm处,可扪及约2.5 cm× 3.0 cm肿块,性质同前.再次行右乳包块切除术,术后病理：右乳腺叶状肿瘤复发并恶变（恶性叶状肿瘤）（图1b）.     

99mTc-MIBI显像在乳腺癌诊断中的应用

目的 :寻找有效和无创性诊断乳腺癌及腋窝淋巴结转移的方法。方法 :对 36例乳腺肿瘤患者进行了乳腺及其区域淋巴结 99m　Tc MIBI显像。全部肿瘤经病理证实。结果 :36例乳腺肿瘤中 14例为良性肿瘤 ,2 2例为乳腺癌 ,其中腋窝淋巴结转移者 13例。99mTc MIBI显像诊断乳腺肿瘤假阳性 1例 ,假阴性 4例 ,其灵敏度为 81 8% ,特异性为 92 6 % ,准确性为 86 1% ;99mTc MIBI显像诊断乳腺癌腋窝淋巴结转移假阴性 5例 ,未发现假阳性 ,其灵敏度为 10 0 % ,特异性为 6 1 5 % ,准确性为 77 3%。结论 :99m　Tc MIBI显像诊断乳腺恶性肿瘤灵敏度较高 ,是一种有效的无创性诊断方法 ,也有助于诊断乳腺癌腋窝淋巴结转移 ,但是其结果还不够理想 ,有待于进一步研究。     

乳腺常规超声与超声造影对早期乳腺癌的诊断价值

目的探讨乳腺常规超声与超声造影对早期乳腺癌的诊断价值。方法选取2016年5月至2019年5月间西安交通大学第二附属医院收治的80例早期乳腺癌患者进行回顾性研究,所有患者分别进行常规超声检查和超声造影检查。分析良恶性乳腺肿瘤的特征,并与穿刺或术后病理结果进行比较,分析两种检测方法的诊断价值。结果超声造影结果提示,乳腺恶性肿瘤主要为不均匀增强及周边增强,乳腺良性肿瘤主要为无增强和均匀增强为主。33例患者经常规超声诊断,良性16例,恶性17例,其中误诊10例(4例误诊为良性,6例误诊为恶性); 47例患者经超声造影诊断,良性12例,恶性35例,其中误诊5例(良性误诊2例、恶性误诊3例)。常规超声诊断良恶性乳腺疾病的敏感性、特异性、阳性预测值和阴性预测值分别为64. 7%、75. 0%、73. 3%和66. 7%。超声造影诊断良恶性乳腺疾病的敏感性、特异性、阳性预测值和阴性预测值分别为94. 1%、76. 9%、91. 4%和83. 3%。超声造影的敏感度明显高于常规造影,差异有统计学意义(P <0. 05)。结论常规超声联合超声造影可提高早期乳腺癌的诊断敏感度,在早期乳腺癌的诊断以及良恶性肿瘤的鉴别诊断中有重要的临床应用价值。     

Detecting mediastinal lymph node metastases in non-small-cell lung cancer using a combination of technetium-99m tetrofosmin chest single photon emission computed tomography and chest computed tomography

The staging of non-small-cell lung cancer (NSCLC) to detect mediastinal lymph node (MLN) metastases is very important for determining the therapeutic strategy.

Methods: Thirty-four patients with proven NSCLC were enrolled in this study. All patients underwent chest computed tomography (CT) and technetium-99m (Tc-99m) tetrofosmin chest single photon emission computed tomography (SPECT) preoperative staging. Mediastinal lymph node metastases were determined on the basis of postoperative pathologic findings to compare the diagnostic accuracy of chest CT with that of Tc-99m tetrofosmin chest SPECT.

Results: Tc-99m tetrofosmin chest SPECT showed a diagnostic accuracy rate of 85.3% in detecting MLN metastases. Chest CT had an accuracy rate of 73.5%. If either Tc-99m tetrofosmin chest SPECT or chest CT with positive findings was considered as positive findings, the sensitivity was 94.7%. If either Tc-99m tetrofosmin chest SPECT or chest CT with negative findings was considered as negative, the specificity was 93.3%.

Conclusion: Tc-99m tetrofosmin chest SPECT was more accurate than chest CT in detecting MLN metastases in NSCLC patients. In addition, the combined use of Tc-99m tetrofosmin chest SPECT and chest CT could significantly increase the sensitivity and specificity compared with the single use of either Tc-99m tetrofosmin chest SPECT or chest CT.     

Utilization of Professional Supportive Care Services by Women with Breast Cancer

Purpose.To assess the value of 99m-Tc-tetrofosmin (tetrofosmin) scintigraphy in patients with palpable and non-palpable breast lesions. Patients and methods.Prospective, blinded trial. One hundred and fifty-nine consecutive patients with 163 breast lesions detected by clinical examination and mammography were included. Tetrofosmin scintigraphy of the breast was performed additionally to the regular diagnostic procedure. Using histologic assessment as the golden standard, sensitivity, specificity, positive and negative predictive value for tetrofosmin scintigraphy of the breast were assessed. Results.Overall sensitivity and specificity were 82% and 84%. The sensitivity for palpable tumors (65%) was 93% compared to 62% for non-palpable breast lesions. Malignant lesions were nearly twice as big as benign lesions (31.5mm±2.4 vs. 16.9mm±2.4). Specificity, positive and negative predictive value (84%, 89%, and 66%) did not differ significantly in palpable versus non-palpable tumors. Of malignant tumors 18% were found false negative by tetrofosmin scintigraphy. Conclusion.The results suggest that tetrofosmin scintigraphy is a valuable tool for the evaluation of palpable breast cancer. In patients with non-palpable tumors, tetrofosmin scintigraphy may not add to the work-up of patients with breast cancer due to a low sensitivity rate.     

99mTc-tetrofosmin SPECT诊断肺部肿瘤和纵隔淋巴结转移的临床价值

背景与目的肺癌切除术前准确的肿瘤分期是手术成功的前提,因此有必要无创性诊断肺部肿瘤及其侵犯的真实范围。本研究的目的是评价99mTc-tetrofosmin SPECT（99mTc-TF SPECT）这种功能显像在诊断肺部肿瘤及纵隔淋巴结转移中的临床应用价值。方法对33例肺部肿块患者于术前或穿刺前一周内行胸部99mTc-TF SPECT显像,以病理结果为参照,计算99mTc-TF SPECT和CT诊断肺癌及纵隔淋巴结转移的灵敏度、特异性和准确性,并加以比较。结果99mTc-TF SPECT诊断肺癌的灵敏度、特异性、准确性、阳性预测值及阴性预测值分别为95.7%、80.0%、90.9%、91.7%和88.9%,CT分别为73.9%、70.0%、72.7%、85.0%和53.8%;99mTc-TF SPECT诊断纵隔淋巴结转移的灵敏度、特异性、准确性、阳性预测值及阴性预测值分别为93.3%、75.0%、87.0%、87.5%和85.7%,CT则分别为60.0%、75.0%、65.2%、81.8%和50.0%。99mTc-TF SPECT诊断肺癌的灵敏度明显高于CT（P〈0.05）。结论99mTc-TF能在术前无创地探测肺癌的原发灶和纵隔淋巴结转移灶,在肺癌的诊断和分期中具有重要的临床实用价值。     

Breast cancer axillary lymph node metastasis detection by a high-resolution dedicated breast camera: a comparative study with SPECT and pinhole SPECT

We evaluated the usefulness of (99m)Tc-tetrofosmin planar scintigraphy acquired with a high-resolution (HR) dedicated breast camera in comparison with conventional single-photon emission computed tomography (SPECT) and pinhole-SPECT (P-SPECT) in breast cancer (BC) axillary lymph node metastasis detection in a consecutive series of 76 BC patients, 28 of whom had axillary lymph node metastases, including 9 positive at clinical examination. HR planar scintigraphy was true positive in only 7 patients with >3 palpable metastases (sensitivity: 25%), while SPECT was true positive in 23 of 28 cases (sensitivity: 82.1%) and P-SPECT in 25 of 28 (sensitivity: 89.3%). SPECT was false negative in 5 patients with nonpalpable 3 metastatic nodes. SPECT should be preferred, significantly improving the sensitivity of planar scintigraphy, especially when using a pinhole collimator.     

(99M)Technetium-sestamibi scintimammography in non-palpable breast lesions found on screening X-ray mammography.

OBJECTIVE: The sensitivity and specificity of (99m)Tc-sestamibi scintimammography in patients with non-palpable breast lesions diagnosed by screening mammography and the value of (99m)Tc-sestamibi to detect axillary lymph node metastases was determined. METHODS: Between September 2000 and December 2003, 103 females with non-palpable breast lesions were included for further evaluation. X-ray mammography was repeated and 99mTc-sestamibi scintimammography performed within one-week. Anterior, and left and right lateral images were obtained. The scintimammography was analysed by 2 experienced observers who were blinded to the clinical, pathological, and radiological results. The sensitivity and specificity of scintimammography to diagnose non-palpable lesion(s), including the axillary regions, was compared with histopathology, clinical, and radiological follow up. RESULTS: Two patients (one non-small lung cancer and one non-Hodgkin's disease) were excluded. Both showed (99m)Tc-sestamibi avid lesions in the breast and axillary region. In the remaining 101 patients, 37 true positive (TP), 4 false positive (FP), 52 true negative (TN), and 8 false negative (FN) breast carcinomas were found. The specificity was 92.8%, sensitivity 82.2%, positive predictive value (PPV) 90.2%, and negative predictive value (NPV) 86.6%. (99m)Tc-sestamibi scintimammography showed axillary lesions in 5/15 (33%) patients with axillary lymph node metastasis. CONCLUSION: In patients with non-palpable lesions diagnosed by screening- X-ray-mammography, (99m)Tc-sestamibi scintimammography provided high specificity and PPV. Furthermore, (99m)Tc-sestamibi scintimammography detected 33% of patients with axillary lymph node metastases. Therefore, (99m)Tc-sestamibi scintimammography could be of incremental value in the surgical work-up of these patients.     

Clinical utility of 99mTc-Sestamibi scintimammography in the management of equivocal breast lesions

The aim of this study was to assess the utility of 99mTc-sestamibi scintimammography (SM) in patients with suspected primary or recurrent breast cancer. Forty-four (44) breast lesions (17 with suspected recurrence of disease) in 40 patients were included into the study. In these patients, the results of conventional diagnostic methods were equivocal or inconclusive. Twenty-one (21) lesions were palpable and 23 lesions were not. Histological examinations performed during the follow-up revealed malignancy in 24 specimens. SM correctly identified 21 of them, as well as 12 true negatives. There were 8 false-positive studies; therefore, the sensitivity of SM was 87.5%, specificity was 60%, positive predictive value (PPV) was 72.4%, and the negative predictive value (NPV) was 80%. The sensitivity in palpable lesions was 100%; three (3) false negatives, 1 recurrence, and 2 cancers, all of them nonpalpable. In conclusion, SM is useful in equivocal palpable lesions for resolving diagnostic uncertainty after conventional examination, and can limit the number of surgical interventions for benign disease. However, its use in nonpalpable tumors is not recommended.     

The usefulness of 99mTc-tetrofosmin SPECT scintimammography in the detection of small size primary breast carcinomas

The aim of this study was to evaluate the usefulness of supine 99mTc-tetrofosmin SPECT in the detection of small size breast carcinomas (BC), for which planar scintimammography has showed a low sensitivity. We studied 93 patients with breast lesions 相似文献   

THE CLINICAL SIGNIFICANCE OF ~(99m)Tc-MIBI BREAST IMAGING IN THE DIAGNOSIS OF EARLY BREAST CANCER

The incidence of breast cancer is increasing in China and it will be the most common malignant tumor in women in the early stage of this century[1]. 99mTc-MIBI breast imaging, an effective, sensitive, specific and noninvasive diagnostic method of breast cancer, has been attracting the attention of physicians. From March, 1994 to September, 1999, 109 breast masses smaller than 2 cm in diameter in 102 patients in Huashan Hospital were divided into three groups to undergo 99mTc-MIBI breast i…