99Tcm-MIBI透视三维显示诊断胸部病变的临床价值

评估^99Tc^m－甲氧基异丁基异腈透视三维显示法对胸部恶性病变及其在相邻部位转移灶检出方面较平面及断层显像所具有的优势。方法 回顾性分析54例恶性和6例良性经手术或病理检查证实的胸部病变，并将SPECT透视三维法与X线胸片、CT等对照研究。结果 正常对照组16例均为阴性；恶性病变组中肺癌38例，平面显像阳性率52．6％，断层阳性率78．9％，透视三维法阳性率84．2％；食管癌12例，平面阳性率41．6％，断层阳性率58．3％，透视三维法阳性率75．0％；4例纵隔及腋下恶性病变平面显像和X线无异常，CT阴性，透视三维法阳性。结论 透视三维法检出病灶优于平面和断层显像，与X线胸片、CT、纤支镜比较，灵敏度、特异性相对均衡，准确性高。

Clinical value of 99 Tcm-MIBI SPECT and 3D display for evaluating malignant lesions in thorax

Objective This study investigated the diagnostic accuracy of 99Tc m-MIBI and 3 dimension (3D) display (MIP) for evaluating the malignant lesions in thorax. Methods SPECT with 99Tc m-MIBI and 3D display were used to evaluate 16 normal subjects and 60 patients suspected with malignant lesions in the thorax. All patients also underwent X-ray and CT examinations. Results All images of 16 normal subjects were negative. In lung cancer group (38 cases), positive rate of planar scintigraphy, SPECT and 3D display were 52.6%, 78.9% and 84.2%, respectively. In esophagus cancer group (12 cases), positive rate were 41.6%, 58.3% and 75.0%. In other groups of lesions in mediastinum and in axillary fossae (4 cases), there was 100% positive by 3D display, but negative by planar scintigraphy, X-ray and CT. Conclusions SPECT imaging with 99Tc m-MIBI and 3D display is reliable. The sensitivity, specificity and accuracy of the method are superior to planar imaging, tomographic scintigraphy, X-ray and CT in distinguishing lesions in the thorax.