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刘海燕,李思进,王艳艳,武志芳,任媛,李险峰,刘建中,胡光.^99mTcN-NOET双时相SPECT探测肺癌纵隔淋巴结转移的临床价值[J].中国医学影像技术,2008,24(8):1257~1260

^99mTcN-NOET双时相SPECT探测肺癌纵隔淋巴结转移的临床价值

Clinical value of ^99mTcN-NOET dual-phase SPECT in detecting mediastinal lymphnode metastasis of patients with lung cancer

投稿时间：2008-04-07 修订日期：2008-05-26

DOI：

中文关键词: ^99mTcN-NOET 肺肿瘤纵隔淋巴结转移

英文关键词:^99mTcN-NOET Lung neoplasms Mediastinal lymphnode metastasis

基金项目:

作者	单位	E-mail
刘海燕	山西医科大学第一医院核医学科,山西太原 030001
李思进	山西医科大学第一医院核医学科,山西太原 030001	lisj-nm@sohu.com
王艳艳	山西省肿瘤医院放射科,山西太原 030001
武志芳	山西医科大学第一医院核医学科,山西太原 030001
任媛	山西省肿瘤医院核医学科,山西太原 030001
李险峰	山西医科大学第一医院核医学科,山西太原 030001
刘建中	山西医科大学第一医院核医学科,山西太原 030001
胡光	山西医科大学第一医院核医学科,山西太原 030001

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中文摘要:

目的探讨^99mTcN-NOET双时相SPECT探测肺癌纵隔淋巴结转移(MLM)的价值。方法 29例经X线检查示肺部阴影疑肺癌的患者术前1周内进行^99mTcN-NOET SPECT早期、延迟胸部断层显像和CT检查,所有病例检查前均未经放、化疗和手术治疗。根据术后病理结果分组,MLM组(G1)11例,共34处MLM;无MLM组(G2)18例。^99mTcN-NOET图像根据纵隔内淋巴结区是否有异常浓聚,判断是否有淋巴结转移。半定量分析采用计算机感兴趣区(ROI)技术,计算肿瘤与正常组织(ROI₁/ROI₂)放射性比值即摄取比值(T/N)。采用重复测量方差分析进行各组的ER、DR、RI%差异的分析,P<0.05 有统计学意义。结果 ①G1中NOET早期阳性显像72.7%(8/11);G2中77.8%(14/18)的患者阴性显像。NOET延迟阳性显像45.4%(5/11);G2中88.9%(16/18)的患者阴性显像。而CT结果显示有54.5%(6/11)纵隔淋巴结转移。G2中83.3%(15/18)的患者显示阴性。⁹⁹Tc^mN-NOET早期显像诊断MLM的灵敏度、特异性和准确性分别为72.7%、77.8%、75.9%,延迟显像分别为45.5%、88.9%、72.7%;CT检查分别为54.5%、83.3%、72.4%。②G1的ER为1.26±0.11,DR为1.38±0.15;G2的ER为1.28±0.17,DR为1.43±0.22,两组DR均高于ER(P<0.001)。两组ER、DR 和RI%间的差别均无统计学意义(P>0.05)。结论 ^99mTcN-NOET双时相SPECT可以用于探测肺癌纵隔淋巴结是否转移,其灵敏度及特异性与常规CT没有差别。肺癌患者进行^99mTcN-NOET显像时的半定量指标与MLM无关,并且随着时间的延长,肺癌患者无论有无MLM,肿瘤清除NOET 均较对侧正常肺组织缓慢。

英文摘要:

Objective To investigate the value of ^99mTcN-NOET dual-phase SPECT in detecting mediastinal lymphnode metastasis (MLM) of pts with lung cancer. Methods ^99mTcN-NOET early and delay SPECT and CT were performed on 29 pts suspected with lung cancer before operated in one week. All cases didn’t accept the radiotherapeutic, chemotherapeutic and operation before checks. According to pathologically results, 29 pts were divided into two groups: 11 pts with MLM (group 1, G1), the total of 34 MLM; 18 pts without MLM (group 2, G2). To determine whether there is MLM according to the abnormal=concentration of nodules lymphaticus of mediastinum. Semiquantitative analysis applied by ROI. The T/N was tumor counts/normal tissue counts and was consisted of early T/N (ER) and delay T/N (DR). Retention index (RI%)=(DR－ER)/ER×100%. The difference of ER, DR and RI% of two groups was analyzed by repeated measurement. P<0.05 was statistical significance. Results ①NOET early imaging showed that 72.7% (8/11) pts in G1 with MLM and 77.8% (14/18) pts in G2 without MLM. NOET delay imaging showed that 45.4% (5/11) of pts with MLM and 88.9% (16/18) pts in G2 without MLM. The CT showed that 54.5% (6/11) of pts with MLM. The sensitivity, specificity and accuracy of NOET early differential diagnosis of MLM were 72.7%, 77.8%, 75.9% respectively; NOET delay were 45.5%, 88.9%, 72.7%. CT scan were 54.5%, 83.3%, 72.4%. ②ER of G1 was 1.26±0.11, DR of G1 was 1.38±0.15; ER of G2 was 1.28±0.17, DR of G2 was 1.43±0.22. ER, DR and RI% of G2 higher than G1 (P>0.05). Conclusion ^99mTcN-NOET dual-phase SPECT could be used to detecting MLM of lung cancer and there was no difference with CT. The semiquantitative indexes had nothing to do with MLM. Moreover, we found that the lung lesion washed out NOET slower than opposite side normal lung in spite of MLM with the time prolong after injection.

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