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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 61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,60%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(3.08±1.67)明显高于良性病灶(1.36±0.64),P<0.01。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-MDP L/C(3.76±1.37)与良性病灶L/C(3.10±1.05)比较差异无显著性(P>0.05)。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 use of 99 Tcm-MIBI and 99 Tcm-MDP in differentiative diagnosis of malignant and benign bone lesions and in the assessment of tumor response to chemotherapy. Methods 61 patients with various bone pathologies (41 malignant and 20 benign lesions) were studied with both imaging agents. Planar 99 Tcm-MIBI scintigraphy was performed 30 min after injection of 740 MBq of 99 Tcm-MIBI. Within 3 days after 99 Tcm-MIBI study, the planar local and whole body bone scan were done 30 min and 3 h after injection of 740 MBq of 99 Tcm-MDP, respectively. Results With 99 Tcm-MIBI imaging, most malignant focuses (73%) clearly showed medium-high radioactivity accumulation. Most benign focuses (60%) had not obviously visible uptake of 99 Tcm-MIBI. In quantitative analysis, the mean lesion/contralateral (L/C) ratio of malignant lesions (3.08±1.67) was significantly higher than that of benign counterparts (1.36±0.64, P<0.01). About 99 Tcm-MDP bone scan: Most malignant or benign lesions showed visible medium-high uptake of 99 Tcm-MDP, but L/C (3.76±1.37) of malignant focuses versus that of benign focuses (3.10±1.05) was of no significantly difference (P>0.05). 6 cases with malignant tumor underwent both pre- and post-therapy 99 Tcm-MIBI and 99 Tcm-MDP evaluation, respectively. It was demonstrated that chemotherapy was able to inhibit MIBI uptake. Conclusions 99Tcm-MIBI imaging gave a good reflection of the effectiveness of therapy. Combined application of two imaging agents was able to provide best clinical value in differentiative diagnosis and in evaluation of the therapy of malignant and benign bone lesions.