99mTc-methoxyisobutylisonitrile SPECT显像评估脑肿瘤治疗后复发与坏死

[目的]评价99mTc-methoxyisobutylisonitrile(MIBI)脑SPECT显像在鉴别脑肿瘤治疗后放射性坏死与复发的应用价值.[方法]对正常对照组5例、经手术或X刀治疗后的脑肿瘤患者20例行99mTc-MIBI脑SPECT早期及延迟显像,并将结果进行双盲比较.[结果]正常对照组两侧大脑半球脑实质呈对称放射性空白区,双侧侧脑室的脉络丛对称显影清晰.半定量分析发现:坏死组与复发组早期摄取比值(P=0.001)、延迟摄取比值(P=0.001)、滞留指数(P=0.003)之间均有显著性差异;各组早期摄取比值与延迟摄取比值之间(P=0.75,P=.38)均无显著性差异.坏死组与复发组正常值95%的可信区间分别为(1.41,2.60)、(3.11,5.11),其中假阳性1例,假阴性1例.[结论]99mTc-MIBI脑SPECT显像可帮助区分颅内肿瘤手术或立体定向放射治疗后的放射性坏死与复发,方法简单,操作简便,有重要的临床应用价值.

Application of 99mTc-MIBI SPECT Brain Imaging in Differentiating Necrosis and Recurrence of Post-therapeutic Brain Tumors

[Objective] To evaluate the application value of 99mTc-MIBI single photon emission computed tomography (SPECT) brain imaging in differentiating the radioactive necrosis or recurrence of post-therapeutic brain tumors. [Methods] Five healthy people (control) and 20 after-surgery brain-tumor patients were performed with early and delayed 99mTc-MIBI SPECT brain imaging. And the results were contrasted by two-blind-trial. [Results] Among all the lestes in the control group, the cerebral substance on both sides of the brain assumes symmetrical radioactive blankness, and the bilateral choroids plexus were clearly and symmetrically imaged. Semiquantification analysis showed that there was a significant difference between the necrosis group and the recurrence group in the early uptake ratios (P=0.001), the delayed uptake ratios (P=0.001), and the retention ratios (P=0.003). Within groups, there was no significant difference between the early uptake ratios and the delayed uptake ratios (P=0.75;P=0.38). And there was one false-positive case and one false-negative case respectively. [Conclusion] 99mTc-MIBI SPECT imaging is helpful in differentiating radioactive necrosis and recurrence of post-therapeutic brain tumors. It can be easily operated and can be applied clinically.