99Tcm-RBC显像诊断眼眶海绵状血管瘤

目的 探讨99Tcm-RBC显像用于诊断眼眶海绵状血管瘤(OCH)的临床价值.方法 41例经术后病理学检查确诊的眼眶肿瘤患者(其中OCH 10例)行99Tcm-RBC显像.先后采集动脉血流灌注相、早期血池相及延迟血池相图像.同时所有患者均进行超声、CT检查,15例患者行MRI检查.采用SPSS 11.5软件进行统计学分析.结果 10例OCH患者99Tcm-RBC显像均表现为典型的海绵状血管瘤征象:动脉血流灌注相及早期血池相无放射性分布,延迟血池相放射性明显浓聚;而其他眼眶肿瘤均未见此影像特征.延迟血池相10例OCH患者的肿瘤与对侧镜像区放射性(L/N)比值为2.96±0.05,明显高于31例非0CH眼眶肿瘤患者(1.14±0.25;t=15.18,P＜0.001).所有OCH患者均被99Tcm-RBC显像正确诊断.10例OCH中,超声正确诊断9例,另有1例假阳性;CT和MRI检查均未做出单一、明确的定性诊断.结论 99Tcm-RBC显像在OCH的定性诊断上具有临床价值,可与超声、CT检查互补成为临床诊断OCH的常规方法之一.

The application of 99Tcm-RBC scintigraphy in the diagnosis of orbital cavernous hemangioma

Objective The purpose of this study was to evaluate the clinical value of 99Tcm-RBCscintigraphy in the diagnosis of orbital cavernous hemangioma (OCH). Methods Forty-one patients with pathologically confirmed orbital mass, of which 10 were OCH, underwent 99Tcm-RBC scintigraphy in this study. The scanning procedure included an initial perfusion phase, followed by an early and a delayed blood pool phase. All patients underwent ultrasonography and CT, and 15 patients also underwent MRI. SPSS 11.5 was used to analyse the data. Results All 10 OCH patients had no abnormal findings on radionuclide angiographic images and early blood pool phase , but increased activity was found during delayed blood pool phase. All the other non-OCH orbital tumors did not have this tracer pattern. The radioactivity ratios of the lump to non-lump (L/N) were 2.960.05 and 1.14±0.25, respectively, which had a statistically significant difference (t=15.15, P＜0.001). When 9 of 10 OCH patients were dignosed correctly with 1 false positive case by ultrasoud, both CT and MRI could not provide definitive diagnosis. Conclusions 99Tcm-RBC scintigraphy is a reliable and useful procedure for the diagnosis of OCH. It may be considered as one of the routine clinical screening tools for the diagnosis of OCH and as a complement investigation to ultrasonography and CT.