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目的 对比分析99Tcm 甲氧基异丁基异腈 (MIBI)和99Tcm 亚甲基二膦酸盐 (MDP)对骨良恶性病变的诊断价值和疗效评估。方法 6 1例临床拟诊骨良恶性病变患者分别进行 2项骨显像 ,其中 6例恶性肿瘤患者分别进行化疗前后显像。显像后均经手术、病理检查对比分析。结果 99Tcm MIBI显像 :73 %恶性肿瘤病灶肉眼见中、高度MIBI浓聚 ,6 0 %良性病灶肉眼未见MIBI聚集。恶性病灶部位与对侧正常组织放射性计数比值 (L C)即99Tcm MIBI摄取比值 (3 0 8± 1 6 7)明显高于良性病灶(1 36± 0 6 4) ,P <0 0 1。99Tcm MDP显像 :大多数恶性或良性病灶肉眼见中、高度MDP浓聚 ,但恶性病灶99Tcm MDPL C(3 76± 1 37)与良性病灶L C(3 10± 1 0 5 )比较差异无显著性 (P >0 0 5 )。化疗可以抑制99Tcm MIBI摄取 ,99Tcm MIBI摄取程度与99Tcm MDP比较能较好反应治疗效果。结论 99Tcm MIBI对鉴别诊断良恶性骨病和评估疗效有较好的应用价值 ,与99Tcm MDP显像联合应用可更全面地提供信息
Objective To compare the diagnostic value and therapeutic effect of 99Tcm methoxyisobutylisonitrile (MIBI) and 99Tcm methylene diphosphonate (MDP) on benign and malignant bone lesions. Methods Six cases of benign bone lesions were performed in 61 cases of benign and malignant bone lesions, and 6 cases of malignant tumors were examined before and after chemotherapy. After imaging were compared by surgery, pathological examination. Results 99Tcm MIBI scintigraphy: 73% of the malignant lesions had moderate and high concentrations of MIBI, and 60% of benign lesions had no MIBI aggregation. The radioactivity count ratio (LC) of malignant lesion site and contralateral normal tissue (99Tcm) was significantly higher than that of benign lesions (38±0.67), P<0.01.99Tcm MDP. Imaging: The majority of malignant or benign lesions showed moderate to high concentration of MDP, but there was no significant difference between malignant lesions 99Tcm MDPL C (3 76± 1 37) and benign lesions LC (3 10±105) (P >0 0 5 ). Chemotherapy can inhibit 99Tcm MIBI uptake, 99Tcm MIBI uptake and 99Tcm MDP can better reflect the therapeutic effect. Conclusion 99Tcm MIBI has a good application value in the differential diagnosis of benign and malignant bone diseases and evaluation of efficacy, and the combined application of 99Tcm MDP imaging can provide more comprehensive information.