~（99m）Tc-MIBI SPECT和SPECT/CT同机融合显像在口腔颌面部肿瘤诊断中的价值
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摘要
[目的]探讨~(99m)Tc-MIBI SPECT、SPECT/CT显像在口腔颌面部良恶性肿瘤定性、定位诊断中的应用价值,为临床手术前鉴别诊断,制定治疗方案提供参考。
[方法]本研究分为两部分:第一部分青岛大学医学院附属医院口腔颌面外科住院治疗的口腔颌面部肿瘤病人40例,检查前患者均静脉注射~(99m)Tc-MIBI后行SPECT早期和延迟头颈部断层显像,结果与CT检查结果比较,以术后病理学结果为标准,对比研究SPECT和CT在口腔颌面部肿瘤定性诊断的价值。第二部分青岛大学医学院附属医院口腔颌面外科住院治疗的腮腺肿块病人30例,术前患者均静脉注射~(99m)Tc-MIBI后行SPECT早期和延迟头颈部断层显像,以术后病理学结果为标准,对SPECT平面显像结果和SPECT/CT同机融合显像结果比较,评价SPECT/CT在腮腺肿块定性、定位诊断的价值。
[结果]第一部分~(99m)Tc-MIBI SPECT在定性、定量诊断口腔颌面部良恶性肿瘤有统计学意义(p<0.05),在腮腺区肿瘤诊断优于口腔颌面部其它部位的肿瘤;CT影像学检查统计学意义不显著。~(99m)Tc-MIBI显像和CT检查的敏感度、特异性和准确性分别为63.63%、83.33%、72.50%和54.54%、72.22%、62.50%,经分析~(99m)Tc-MIBI显像灵敏性与CT的灵敏性的差别有统计学意义(p<0.05);二者的特异性、准确性的差别统计学意义不显著(p>0.05)。第二部分~(99m)Tc-MIBISPECT/CT同机融合显像对腮腺肿瘤的敏感度、特异性和准确性分别是84.61%、94.12%、90.00%;SPECT/CT同机融合在腮腺区良恶性肿瘤的鉴别有显著的统计学意义(p<0.05);腮腺良性肿块组和恶性肿瘤组的SPECT/CT~(99m)Tc-MIBI T/N值分别为1.42±0.62,2.32±0.58,两者差别有统计学意义(p<0.05)。
[结论]1~(99m)Tc-MIBI SPECT的灵敏性高于CT的灵敏性,可以作为CT鉴别口腔颌面部良恶性肿瘤的一种补充,在鉴别腮腺区良恶性肿瘤优于颌面部其它部位肿瘤。2~(99m)Tc-MIBI SPECT/CT同机融合显像对腮腺区肿块鉴别有较高的诊断价值。
[Objective]To study the value of ~(99m)Tc-MIBI SPECT imaging and SPECT/CT fusion imaging in oral and maxillofacial tumor,to provide a reference of preoperative differential diagnosis and treatment.
[Methods]The first part:40 patients with maxillofacial masses were enrolled.After intravenous administration of ~(99m)Tc-MIBI,static planar imaging and fusion imaging of head and neck were obtained,their results compared with CT and pathology.The second part:30 patients with maxillofacial tumor were enrolled.After intravenous administration of ~(99m)Tc-MIBI,static planar imaging and fusion imaging of head and neck were obtained.Compared static planar imaging with fusion imaging,to investigated the clinical value of SPECT/CT in parotid gland masses.
[Results]1 There was significant difference in ~(99m)Tc-MIBI SPECT static planar imaging to differention diagnosis of benign and malignant maxillofacial tumor.The diagnosis of parotid gland tumor were better than the other areas in maxillofacial tumor.2 The sensitivity,specificity and accuracy of ~(99m)Tc-MIBI SPECT/CT fusion imaging to differention diagnosis of benign and malignant parotid gland tumor;Ratio of SPECT ~(99m)Tc-MIBI T/N of two groups were 1.42±0.62,2.32±0.58,there was signification differention to two groups.
[Conclusion]1 SPECT'S sensitivity was higher than CT,it could be looked as a routine method to differention diagnosis of benign and malignant oral and maxillofacial tumor,diagnosis of parotid gland tumor were better than the other areas in oral and maxillofacial tumor,if necessary,SPECT combined with CT may play an important role in diagnosis of the maxillofacial tumor.2 ~(99m)Tc-MIBI SPECT/CT fusion imaging is a very useful tool in diagnosing the parotid gland tumor.
[方法]本研究分为两部分:第一部分青岛大学医学院附属医院口腔颌面外科住院治疗的口腔颌面部肿瘤病人40例,检查前患者均静脉注射~(99m)Tc-MIBI后行SPECT早期和延迟头颈部断层显像,结果与CT检查结果比较,以术后病理学结果为标准,对比研究SPECT和CT在口腔颌面部肿瘤定性诊断的价值。第二部分青岛大学医学院附属医院口腔颌面外科住院治疗的腮腺肿块病人30例,术前患者均静脉注射~(99m)Tc-MIBI后行SPECT早期和延迟头颈部断层显像,以术后病理学结果为标准,对SPECT平面显像结果和SPECT/CT同机融合显像结果比较,评价SPECT/CT在腮腺肿块定性、定位诊断的价值。
[结果]第一部分~(99m)Tc-MIBI SPECT在定性、定量诊断口腔颌面部良恶性肿瘤有统计学意义(p<0.05),在腮腺区肿瘤诊断优于口腔颌面部其它部位的肿瘤;CT影像学检查统计学意义不显著。~(99m)Tc-MIBI显像和CT检查的敏感度、特异性和准确性分别为63.63%、83.33%、72.50%和54.54%、72.22%、62.50%,经分析~(99m)Tc-MIBI显像灵敏性与CT的灵敏性的差别有统计学意义(p<0.05);二者的特异性、准确性的差别统计学意义不显著(p>0.05)。第二部分~(99m)Tc-MIBISPECT/CT同机融合显像对腮腺肿瘤的敏感度、特异性和准确性分别是84.61%、94.12%、90.00%;SPECT/CT同机融合在腮腺区良恶性肿瘤的鉴别有显著的统计学意义(p<0.05);腮腺良性肿块组和恶性肿瘤组的SPECT/CT~(99m)Tc-MIBI T/N值分别为1.42±0.62,2.32±0.58,两者差别有统计学意义(p<0.05)。
[结论]1~(99m)Tc-MIBI SPECT的灵敏性高于CT的灵敏性,可以作为CT鉴别口腔颌面部良恶性肿瘤的一种补充,在鉴别腮腺区良恶性肿瘤优于颌面部其它部位肿瘤。2~(99m)Tc-MIBI SPECT/CT同机融合显像对腮腺区肿块鉴别有较高的诊断价值。
[Objective]To study the value of ~(99m)Tc-MIBI SPECT imaging and SPECT/CT fusion imaging in oral and maxillofacial tumor,to provide a reference of preoperative differential diagnosis and treatment.
[Methods]The first part:40 patients with maxillofacial masses were enrolled.After intravenous administration of ~(99m)Tc-MIBI,static planar imaging and fusion imaging of head and neck were obtained,their results compared with CT and pathology.The second part:30 patients with maxillofacial tumor were enrolled.After intravenous administration of ~(99m)Tc-MIBI,static planar imaging and fusion imaging of head and neck were obtained.Compared static planar imaging with fusion imaging,to investigated the clinical value of SPECT/CT in parotid gland masses.
[Results]1 There was significant difference in ~(99m)Tc-MIBI SPECT static planar imaging to differention diagnosis of benign and malignant maxillofacial tumor.The diagnosis of parotid gland tumor were better than the other areas in maxillofacial tumor.2 The sensitivity,specificity and accuracy of ~(99m)Tc-MIBI SPECT/CT fusion imaging to differention diagnosis of benign and malignant parotid gland tumor;Ratio of SPECT ~(99m)Tc-MIBI T/N of two groups were 1.42±0.62,2.32±0.58,there was signification differention to two groups.
[Conclusion]1 SPECT'S sensitivity was higher than CT,it could be looked as a routine method to differention diagnosis of benign and malignant oral and maxillofacial tumor,diagnosis of parotid gland tumor were better than the other areas in oral and maxillofacial tumor,if necessary,SPECT combined with CT may play an important role in diagnosis of the maxillofacial tumor.2 ~(99m)Tc-MIBI SPECT/CT fusion imaging is a very useful tool in diagnosing the parotid gland tumor.
引文
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