低剂量<sup>99m</sup>Tc-MIBI乳腺断层双时相显像诊断乳腺癌的临床研究

文美玲; 梁庆模; 包铮; 赵小艳; 郑自贵

doi:10.3969/j.issn.1000-8179.2013.01.010

低剂量^99mTc-MIBI乳腺断层双时相显像诊断乳腺癌的临床研究

doi: 10.3969/j.issn.1000-8179.2013.01.010

南华大学附属南华医院肿瘤内科（湖南省衡阳市421002）

基金项目:

湖南省卫生厅资助项目 06SK3057

详细信息

通讯作者:
梁庆模 hylqm@vip.sina.com

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出版历程
- 收稿日期: 2012-10-15
- 修回日期: 2012-12-27

Clinical value of low dose ^99mTc-MIBI double phase tomographic imaging in diagnosis of breast cancer

Department of Medical Oncology, Affiliated Nanhua Hospital, Nan Hua University of South China, Hengyang 421002, China

Funds:

the Project supported by the Department of Public Health of Hunan Province 06SK3057

More Information

Corresponding author: Qingmo LING; E-mail: hylqm@vip.sina.com

摘要

摘要: 目的探讨低剂量^99mTc-甲氧基异丁基异腈(MIBI)半定量分析在乳腺断层双时相显像诊断乳腺癌中的临床意义。方法 109例乳房肿块患者和26例正常对照者为临床研究对象, 使用自制乳腺显像装置进行早期和延迟图像采集, 图像行半定量分析(SQA), 并与病理检查结果对照。结果正常对照组、良性病变组、乳腺癌组的早期相T/NT比值分别为1.09±0.18、1.77±1.36、3.98±3.11, 3组比较, 差异有统计学意义(P < 0.05)。正常对照组的早期相与延迟相T/NT比值差异无统计学意义[(1.09±0.18)vs.(1.08±0.19), P > 0.05];良性病变组下降, 差异有统计学意义[(1.77±1.36)vs.(1.28±0.83), P < 0.05];乳腺癌组下降不明显, 差异无统计学意义[(3.98±3.11)vs.(3.04±2.46), P > 0.05]。半定量分析诊断乳腺癌的灵敏度为97.67%(42/43), 特异性为81.82%(54/66), 准确性为88.07%(96/109), 阳性预测值为77.78%(42/54), 阴性预测值为98.18%(54/55)。结论低剂量^99mTc-MIBI乳腺断层双时相显像是诊断乳腺癌的一种行之有效的方法, 对鉴别乳腺良恶性病变有很好的临床应用价值。
- 乳腺肿瘤 /
- 低剂量^99mTc-MIBI /
- 半定量分析
Abstract: Objective This study aims to investigate the clinical significance of the semi-quantitative analysis of low-dose ^99mTc-methoxy isobutyl isonitrile(MIBI) double phase tomographic imaging in breast cancer diagnosis. Methods A total of 109 patients with breast lesions and 26 normal breasts underwent double-phase ^99mTc-MIBI tomographic imaging using a self-designed imaging device.The early and the delayed tumor to non-tumor ratios(T/NT) were calculated by semi-quantitative image analysis(SQA).The results were compared with that of the pathological results. Results The early phase T/NT ratios in the normal control, benign, and breast cancer groups were 1.09±0.18, 1.77±1.36, and 3.98±3.11, respectively.The difference was statistically significant(P < 0.05).The difference of the early and delayed phase T/NT ratios in the normal control group was not statistically significant(1.09±0.18 vs.1.08±0.19, > 0.05).The difference in the benign group was statistically significant(1.77±1.36 vs.1.28±0.83, P < 0.05), whereas that of the breast cancer group was not statistically significant(3.98±3.11 vs.3.04±2.46, P > 0.05).The sensitivity of the semi-quantitative analysis in the diagnosis of breast cancer was 97.67%, the specificity was 81.82%, and the accuracy was 88.07%.The positive and negative values were 77.78%(42/54) and 98.18%(54/55), respectively. Conclusion Low dose 99mTc-MIBI double-phase tomography imaging is an effective method to detect breast cancer, and has great clinical value in the differentiation of malignant and benign breast lesions.
- mammary neoplasms /
- low dose^99mTc-MIBI /
- semi-quantitative analysis

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图 1 正常对照者^99mTc-MIBI双时相断层显像呈“阴性”（早期相T/ NT=1.1/1，延迟相T/NT=1.1/1）

Figure 1. ^99mTC-MIBI double phase tomography was"negative"(Early imaging T/NT=1.1/1, Delayed imaging T/NT=1.1/1)in the normal control group

A: Early imaging; B: Delayed imaging

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图 2 ^99mTC-MIBI双时相断层显像呈“阳性”（早期相T/NT=7.3/1，延迟相T/NT=7.3/1），术后病理确诊为左乳浸润性导管癌

Figure 2. ^99mTC-MIBI double phase tomography was"Positive"(Early imaging T/NT=7.3/1, Delayed imaging T/NT=7.3/1), pathologically diagnosed as left breast infiltrating ductal carcinoma

A: Early imaging; B: Delayed imaging

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图 3 ^99mTC-MIBI双时相断层显像呈“弱阳性”（早期相T/NT=3.9/1，延迟相T/NT=2.7/1，延迟显像放射性分布明显减低）

Figure 3. ^99mTC-MIBI double phase tomography showed"Weak Positive"(Early imaging T/NT=3.9/1, Delayed imaging T/NT=2.7/1)

A: Early imaging; B: Delayed imaging

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表 1 109例乳腺肿块放射性浓聚显像情况

Table 1. Radioactive concentration imaging of breast mass in 109 cases

表 2 各组乳腺断层早期和延迟相T/NT比值

Table 2. T/NT ratios of the early and the delayed imaging in each group

表 3 ^9mTc-MIBI双时相断层显像半定量分析结果与组织病理学结果对照

Table 3. Contrast between the results of 99mTc-MIBI tomographic imaging and histopathology

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