18F-FDG符合显像诊断弥漫性胸膜间皮瘤1例报道

胸膜间皮瘤为原发于胸膜间皮细胞的肿瘤,其恶性的自然生存率较低,在4～12月,为临床少见的胸部占位疾病,预后不好.而用常规的CT、MRI影像手段往往因缺乏特征性征象而不能确诊,从而延误治疗时机.笔者在开展18F-FDG符合显像中,发现1例患者,现报道如下.     

99Tcm-HL91与99Tcm-MIBI比较显像对甲状腺冷结节的诊断价值

目的：比较99Tcm-HL91和99Tcm-MIBI显像定性及半定量分析对甲状腺冷结节的诊断价值。方法：对103例99TcmO4-甲状腺扫描提示为冷结节的患者手术前行SPECT亲肿瘤显像,其中99Tcm-HL91显像组35例,99Tcm-MIBI显像组68例;并对两组患者早期和延迟图像的定性和半定量分析结果进行比较。结果：99Tcm-HL91乏氧显像对甲状腺冷结节诊断的准确度和特异度均高于99Tcm-MIBI亲肿瘤显像,差异有显著性（P<0.001）;两种显像方法的敏感度无显著差异。结论：99Tcm-HL91乏氧显像对甲状腺冷结节良恶性的鉴别诊断更具有优越性。     

99TcmO4-与99Tcm-HL91联合显像对甲状腺结节的诊断价值

目的用99Tcm-高锝酸钠（99TcmO4-）与99Tcm-4,9-二氮一3,3,10,10-四甲基十二烷-2,11-二酮（99Tcm-HL91）联合显像鉴别甲状腺结节的性质,评价其临床价值。方法对65例甲状腺结节患者行99TcmO4-动、静态双时相显像,48h后再对其进行99TcmO4-静态显像,显像结果示为冷结节的46例患者再行99Tcm-HL91乏氧显像,最后将两种显像结果与病理活检结果进行对比分析。结果99TcmO4-显像对甲状腺结节诊断的灵敏度、特异度和准确度分别为78．6％、71．9％、73．9％;99Tcm-HL91显像为88．7％、92．3％、91．4％,两者联合显像对甲状腺结节的诊断灵敏度为92．9％、特异度为93．8％、准确度为93．5％。结论99TcmO4-与99Tcm-HL91两种显像方法相结合有助于提高诊断符合率。     

34例肺部结节SPECT-CT的99m Tc-MIBI显像分析

目的 评价同机图像融合技术99mTc-MIBI显像对肺部恶性肿瘤的诊断价值.方法 临床经X线平片或CT扫描发现肺部结节患者34例,共计48个肺部结节样病灶,以GE公司InfiniaHawkeye 4 SPECT-CT行10min及2h延迟胸部断层99mTc-MIBI显像,以ROI技术测定其T/NT比值,并以同机螺旋CT扫描同机图像融合,对早期及延迟图像分别读片,判断显影结果,并对其T/NT比值根据其最终病理结果进行统计分析.结果 34例患者共计48个肺部结节,早期显像阳性结节数21,延迟显像阳性结节数16,(T/NT比值＞3.33),以延迟显像阳性为最终判定标准,肺部恶性病灶其T/NT比值较良性病灶差异有统计学意义(P＜0.05).阴性结节数为27,经手术病检证实13例为肺部恶性肿瘤病灶,假阳性结节数3,假阴性结节数为2,其灵敏度88.88%,特异性90.9%,阳性预测值+PV 84.21%,阴性预测值-PV 93.75%.结论 99mTc-MIBI作为一种肿瘤阳性显像剂,对于肺部占位性病变的灵敏度高,但其特异性不高,而99mTc-MIBI显像和CT扫描,其可提高其诊断价值,与普通SPECT显像相比,灵敏度及特异性均有显著提高.可在不具备PET-CT及符合探测SPECT设备的基层医院及经济欠发达地区运用.

Abstract：

Objective To evaluate the value of the fusion of 99m Tc-MIBI imaging technology apply in the diagnosis of malignant lung tumor. Methods Thirty - four cases with lung nodules proved by X-ray and/or CT scanning, a total of 48 lung nodular lesions. And the imaging with-99m Tc-MIBI of chest performed at 10 minutes and 2 hours delayed after injection by GE Infinia Hawkeye 4 SPECT-CT. then the regions of interesting ( ROI) were drawn in the tumor and contra lateral position to calculate the radioactivity ratios of tumor to normal ( T/NT) , and fused with the spiral CT scanning image in the same machine, and reading the early and delayed image respectively. Judged the result of the image develops, and statistical analysis of the ratio (T/NT) according to the final pathologic consequence. Results All cases with total of 48 nodular lesions, 21 nodules were positive in early imaging, 16 nodules were positive in delayed imaging (the ratio T/NT over 3. 33). defined the delayed image positive as the final criterion, The(T/NT)ratios of Malignant lung lesions were significantly higher than the benign lesions ( P ＜0. 05). Negative nodes 27, 13 cases of lung cancer lesions were malignant, confirmed by postoperative pathologic examination. The falsepositive nodules 3, false-negative nodules 2. The sensitivity was: 88.88%, the specificity was: 90.9% positive predictive value ( +PV) was: 84. 21% , negative predictive value (-PV) is: 93.75%. Conclusion 99mTc-MIBI as a tumor positive imaging agent is highly sensitivity to lung lesions, but specificity is not so high.     

~(99)Tc~mO_4~-与~(99)Tc~m-HL91联合显像对甲状腺结节的诊断价值

目的 用~(99)Tc~m-高锝酸钠(~(99)Tc~mO_4~-)与~(99)Tc~m-4,9-二氮-3,3,10,10-四甲基十二烷-2,11-二酮(~(99)Tc~m-HL91)联合显像鉴别甲状腺结节的性质,评价其临床价值.方法 对65例甲状腺结节患者行~(99)Tc~mO_4~-动、静态双时相显像,48 h后再对其进行呵~(99)Tc~mO_4~-静态显像.显像结果示为冷结节的46例患者再行~(99)Tc~m-HL91乏氧显像,最后将两种显像结果与病理活检结果进行对比分析.结果 ~(99)Tc~mO_4~-显像对甲状腺结节诊断的灵敏度、特异度和准确度分别为78.6%、71.9%、73.9%;~(99)Tc~m-HL91显像为88.7%、92.3%、91.4%,两者联合显像对甲状腺结节的诊断灵敏度为92.9%、特异度为93.8%、准确度为93.5%.结论 ~(99)Tc~mO_4~-与~(99)Tc~m-HL91两种显像方法相结合有助于提高诊断符合率.