SPECT核素动态显像定量评价鼻咽癌放疗后涎腺功能的价值

目的探讨用放射性核素动态显像定量分析方法，评价鼻咽癌患者放疗后涎腺功能损伤情况的可行性.方法对63例鼻咽癌患者在放疗前、后均行SPECT核素动态显像，利用SPECT机的R.O.I sequence 软件对所得数据进行处理，并定量分析涎腺的摄取、排泌功能.结果 63例鼻咽癌患者放疗后，腮腺和颌下腺的排泌功能损伤（无明显损伤、轻度、中度、重度和极度损伤）分别为（19、7、7、4、89）和（22、24、20、12、48），两者比较差异有非常显著性（p<0.005）；腮腺的摄取和排泌功能损伤分别为（51、12、16、6、41）和（19、7、7、4、89），两者比较差异有非常显著性（p<0.005）；颌下腺的摄取和排泌功能损伤分别为（58、8、11、6、43）和（22、24、20、12、48），两者比较差异有非常显著性（p<0.005）.结论 SPECT核素动态显像定量分析方法是评价鼻咽癌患者放疗后涎腺功能受损程度的敏感、实用的方法.放疗后以腮腺功能受损为主，而腮腺、颌下腺的功能损伤又以排泌功能受损为主.

The Value of Quantitative Evaluation of Salivary Gland Function of NPC Patients by SPECT Radioactive Dynamic Imaging

Objective　By making use of SPECT radioactive dynamic imaging, to investigate the possibility of quantitative evaluation of salivary gland function of NPC patients who were treated by radiotherapy.Methods　SPECT radioactive dynamic imaging was executed for 63 NPC patients before and after radiotherapy.We utilized ROI sequence software of SPECT for quantitatively evaluating the ingestion-excretion function of salivary gland. Results　The damage rates of the excretion function of parotid gland and submandibular gland of 63 NPC patients after radiotherapy were 19,7,7,4,89 and 22,24,20,12,48,respectively. The damage rates of the ingestion function and excretion function of parotid gland were 51,12,16,6,41 and 19,7,7,4,89,respectively. The damage rates of the ingestion function and excretion function of submandibular gland were 58,8,11,6,41 and 22,24,20,12,48, respectively. There all were obvious difference between them (p<0.005).Conclusions　SPECT radioactive dynamic imaging is a sensitive and useful method in determining the salivary gland function of NPC patients who were treated by radiotherapy. As to salivary gland function damage of NPC patients who were treated by radiotherapy,the parotid gland function damage is primary. And the excretion function damage is more serious than the ingestion function damage of parotid gland or submandibular gland.