摘要
目的评价99mTc-HL91乏氧显像在鼻咽癌患者特点及其诊断中作用。方法临床确诊的Ⅱ-Ⅳa期初发鼻咽癌患者34例放疗前1周进行系列99mTc-HL91显像,其中18例放疗前行辅助化疗。半定量分析鼻咽部原发灶及颈淋巴结转移的乏氧情况。结果34病例中99mTc-HL91显像阳性30例,阴性4例,对鼻咽癌诊断的敏感性为88.2%,漏诊率为11.8%;阳性病灶的T/Mu、T/Ce值分别为1.39±0.33,3.80±0.88。其中弱阳性8例,直径为0.5～1.2cm,阳性～强阳性22例,直径0.96～3.53cm,平均1.62cm,肿物上下侵袭的范围从0.5～4.6cm。4例阴性的MR检查鼻咽未见明确肿物或可疑结节,25例患者28枚咽旁和颈部淋巴结乏氧显像剂异常浓集(阳性),直径1.857±1.419cm,与乏氧程度无明显相关。乏氧部位平均计数与直径呈正相关(r=0.87,P<0.01);肿瘤病灶对乏氧显像剂的摄取呈浓集-消退趋势,15min乏氧显像已经能够对乏氧病灶定位,阳性病灶数与4h时相同,但周围本底和颈部肌肉摄取值也较高,影像清晰度相对差。结论大多数鼻咽癌原发灶和部分转移淋巴结对99mTc-HL91特异性摄取,99mTc-HL91乏氧显像对鼻咽癌的诊断及放疗靶区定位有一定价值。
Objective To analyze the characteristic and the value of ^99mTc-HL91 SPECT in diagnosis of nasopharyngeal carcinoma （NPC）. Methods 34 NPC patients confirmed by pathology and at the phases of from II to IV a were underwent serial ^99mTc-HL91 SPECT series imaging one week before radiotherapy, 18 of those received assistant chemotherapy. The results of hypoxia of primary nasopharyngeal lesion and neck lymph node metastases were semi - quantitatively analyzed. Results （1）Out of the 34 cases examined by ^99mTc-HL91 SPECT 30 were positive and 4 negative with a sensitivity of 88.2% in diagnosis of NPC. QT/ Mu, T/Ce of positive lesions were 1.39 ± 0.33 and 3.80 ± 0.88, including 8 cases with the size of mild positive lesions of 0.5 - 1. 2cm and 22 cases with positive and stIong positive lesions of 0.96- 3.53cm;there was a positive relationship between T/Mu, T/Ce and size of lesion（ γ = 0.607,0.640, P 〈 0.01 ）; no obvious or suspected lesions were observed in 4 cases with negative imaging. （3）28 lymph nodes at para - pharyngeal and neck in 25 cases showed abnormal imaging （positive lesion） with the size of 1.857 ± 1. 419cm, but without obvious correlation with the extent of hypoxia. （4）There was a decrease tendency in uptakes of ^99mTc-HL91 by NPC cases. The hypoxia lesions could be detected in 15min, but image quality was poorer than that of 4h images. Conclusion Most primary lesions of NPC cases and its metastases can specifically uptake ^99mTc-HL91, thus it is of certain clinical value in diagnosis of NPC and the localization of radiological target.
出处
《中国热带医学》
CAS
2006年第10期1769-1770,1764,共3页
China Tropical Medicine
