99Tcm-HL91显像用于骨转移瘤的诊断

目的 探讨乏氧显像剂99Tcm-4,9-二氮-3,3,10,10-四甲基十二烷-2,11-二酮肟(HL91)在骨转移瘤诊断中的应用价值.方法 27例骨痛患者,其中19例经病理检查证实为骨转移瘤(未行放化治疗),8例为骨良性病变.所有患者均行99Tcm-亚甲基二膦酸盐(MDP)显像,2 d后注射99Tcm-HL91740 MBq,注射4 h后依据99Tcm-MDP显示的病灶进行断层显像,利用感兴趣区(ROI)技术,计算肿瘤与对侧正常组织的放射性(T/N)比值.采用SPSS 11.0软件进行t检验.结果 19例骨转移患者99Tcm-MDP显像提示的85处病灶,有79处99Tcm-HL91显像呈异常放射性浓聚;经病理检查或临床证实的8例骨良性疾病中,99Tcm-MDP显像提示的12处病灶99Tcm-HL91显像全部呈阴性.HL91断层显像骨转移组和骨良性疾病组的T/N比值分别为1.877±0.288和0.735±0.236,差异有统计学意义(t=13.065,P＜0.05).肺癌、前列腺癌骨转移病灶的T/N比值分别为1.915±0.344和1.825±0.175,2种病理类型间差异无统计学意义(t=1.378,P＞0.05).结论 99Tcm-HL91显像在骨骼良恶性病变的鉴别中可能有一定价值.

Preliminary clinical study of 99Tcm-HL91 imaging in bone metastasis

Objective 99Tcm-4,9-diaza-3,3,10,10-tetramethyldodecan-2,11-dione dioxime(HL91),a new type of hypoxic agents,accumulates in tumor hypoxic tissue specifically.The aim of this study was to evaluate the value of 99Tcm-HL91 imaging in the diagnosis of bone metastasis.Methods Nineteen cases with bone metastasis(without any treatment)and 8 cases with benign lesions underwent SPECT imaging at 4 h after injection of 740 MBq of 99Tcm-HL91 along with 99Tcm-methylene diphosphonic acid(MDP)imaging.Regions of interest(ROIs)were drawn in tumor tissue and contralateral normal tissue respectively,and the radioactivity ratios of tumor-to-normal(T/N)were calculated.The t-test was used for data analysis with SPSS 11.0.Results There were visible uptake of 99Tcm-HL91 in 79 out of 85 focuses in 19 patients of bone metastasis;however,there was no obvious uptake of 99Tcm-HL91 in 12 focuses of 8 patients of benign lesions.Significant difference existed between the T/N values of malignant(1.877±0.288)and benign lesions(0.735±0.236);t=13.065,P＜0.05].However,the T/N value of bone metastasis from lung cancer did not differ with that from prostate cancer(1.915±0.344 and 1.825±0.175,respectively;t=1.378,P＞0.05).Conclusion The results indicated that 99Tcm-HL91 was useful in diagnosing the malignant and benign bone lesions.