~(99)Tc~m-HL91在肺部肿瘤诊断中的临床价值

目的　应用99Tcm HL91进行肺部肿瘤阳性显像 ,探讨其在肿瘤良恶性诊断中的临床应用价值。方法　对 42例高度怀疑肺部肿瘤的患者注射99Tcm HL91后行 2h、4h平面显像及 4hSPECT/CT断层融合显像 ,使用ROI技术计算肿块与对侧正常肺组织的比值 (T/N)。结果　恶性组在 2h、4h平面及 4h断层图像上T/N值分别为 1.50±0 .17、1.71± 0 .2 2、2 .72± 0 .75,良性病变组分别为 1.2 1± 0 .10、1.2 5± 0 .2 2、1.49± 0 .3 6,各组间均有显著性差异 (P均 <0 .0 1) ;恶性组 4h延迟平面像组较 2h组T/N比值明显增高 (P <0 .0 1) ,而良性组无明显增高 (P >0 .0 5) ;各病理类型各时相之间无显著性差异 (P <0 .0 5) ;以恶性组横断层T/N值 x -1s为诊断阈值 ,其诊断灵敏度、特异度、准确性分别为 84.85%、88.89%和 85.71% ;以良性组 x + 1s为诊断阈值 ,灵敏度、特异度及准确性分别为 90 .91%、88.89%和 95.2 4%。结论　99Tcm HL91作为一种肿瘤阳性显像剂 ,对肺部肿瘤的定性诊断具有较高价值

Clinical study of 99Tcm-HL91 in diagnosis of pulmonary neoplasms

Objective To evaluate the clinical value of 9 9 Tc m-HL91 as a tumor positive imaging agent in diagnosis of pulmonary neopl asms. Methods We performed 2 h,4 h planar and 4 h tomogr aphy fusion imaging after injection of HL91 on 42 patients with high probability of pulmonary cancer. Tumor-to-normal tissue background (T/N) ratios were meas ured for all scans. Results T/N ratios at 2 h,4 h planar and 4 h transectional imaging in malignant group were 1.50± 0.17 ,1.71±0.22 and 2.72±0.75, respectively; while in benign group, they were 1.21±0.10,1.25 ±0.22 and 1.49±0.36, respectively. 4 h delay T/N ratios in malignant group we re obviously higher than 2 h ( P <0.01), and there was no significant differe nce in benign group ( P >0.05). There were no remarkable differences of T/N ra tios in different phases and histological types of lung carcinoma. Using maligna nt transection ratio ( -1s ) as diagnostic threshold, the sensitivity , specificity and accuracy were 84.85% , 88.89% and 85.71% , respectiv ely. Using transection ratio( +1s ) of benign group as diagnostic th reshold , the sensitivity, specificity and accuracy were 90.91%, 88.89% and 95.2 4%,respectively. Conclusion The results indicate that as a tumor positive imaging agent 99 Tc m-HL91 is useful in diagosising pulmon ary neoplasms.