99Tcm-HL91与99Tcm-MIBI肿瘤阳性显像在肺部肿块诊断中的对比研究

目的比较99Tcm-HL91和99Tcm-MIBI肿瘤阳性显像对肺部单发肿块的诊断效能和影像质量.方法 50例肺部结节或肿块患者,分为恶性组和良性组,术前分别行99Tcm-HL91和99Tcm-MIBI早、晚期平面及断层融合显像,对显像结果进行对照分析.结果①定性诊断HL91组的敏感性为97.30%(36/37例),特异性为69.23%(9/13例);MIBI组诊断的敏感性为83.78%(31/37例),特异性为76.92%(10/13例). 肺门及纵膈肿大淋巴结使用HL91检测的阳性率为91.30%(21/23个); MIBI法为73.91%(17/23个).② HL91法断层显像ROC曲线下的面积(0.953±0.034)较MIBI法(0.857±0.073)高约10%,以T/N值1.76为界点HL91诊断的敏感性为100%(37/37例),特异性为84.62%(11/13例);以1.66为界点MIBI组诊断的敏感性为86.49%(32/37例),特异性为76.92%(10/13例),以1.85为界点MIBI组诊断的敏感性为78.38%(29/37例),特异性为84.62%(11/13例).结论 99Tcm-HL91肺部病变亲肿瘤阳性显像在图像质量和诊断性能上均优于99Tcm-MIBI显像.

Comparison of 99Tcm-HL91 and 99Tcm-MIBI tumor positive imaging in diagnosis of lung neoplasms

Objective To compare the diagnostic value and imaging quality between ⁹⁹Tc^m-HL91 and ⁹⁹Tc^m-MIBI tumor positive imaging about pulmonary neoplasm. Methods Total 50 patients with pulmonary neoplasms examined by spiral CT were selected. All patients were verified by biopsy or surgery, and divided into benign and malignant group. Early and late phase planar and tomography imaging were done in all patients using ⁹⁹Tc^m-HL91 and ⁹⁹Tc^m-MIBI. The visualization and half quantitative methods were used to analyze all imaging. Results The sensitivity and specificity of HL91 imaging were 97.3% and 69.23%, respectively, and 83.78% and 76.92% of MIBI. The positivity rates of lymph gland of lung hilus and mediastinal were 91.30% of HL91 and 73.91% of MIBI. The AUC^ROC of HL91 tomography imaging was 0.953±0.034, about 10% higher than MIBI. A threshold (T/N=1.76) was gained from ROC curve of HL91 4h tomography phase and was used to distinguish the character of pulmonary neoplasm,with sensitivity and the specificity of 100% and 84.62%,respectively. Using 1.66 as the threshold of MIBI image, the sensitivity and the specificity were 86.49% and 76.92%, 78.38% and 84.62% respectively if the threshold of MIBI image was 1.85. Conclusion The diagnosis capability and the imaging quality of ⁹⁹Tc^m-HL91 are superior to that of ⁹⁹Tc^m-MIBI.