99Tcm-octreotide显像在嗜铬细胞瘤定位诊断中的临床应用

摘要

目的:评估9Tcm-octreotide显像在嗜铬细胞瘤定位诊断中的临床应用价值.方法:21例术后经病理诊断为嗜铬细胞瘤患者为实验组.24例有高血压病史但血、尿中的儿茶酚胺,尿中的香草基苦杏仁酸含量均正常的患者为对照组.45例患者以131I-MIBG(间碘苄胍)作为功能显像剂行SPECT定位诊断,同时以99Tcm-octreotide为显像剂行肿瘤生长抑素受体显像.以核素显像感兴趣区(ROI)技术,测定肿瘤/非肿瘤(T/NT)比值.比较99Tcm-octreotide肿瘤受体显像及131I-MIBG全身显像在诊断嗜铬细胞瘤灵敏性、特异性、准确性等的差异.结果:实验组,99Tcm-octreotide显像和131I-MIBG全身显像T/NT比值分别为(3.24±0.43)和(5.35 ±0.32),P＜0.05有明显差异;对照组T/NT比值分别为(1.31 ±0.18)和(1.26±0.25),P＞0.05无明显差异.实验组两种方法诊断嗜铬细胞瘤的灵敏性、特异性、准确性、阳性预测值、阴性预测值分别为83.33％、89.47％、86.48％、88.23％、85.00％和100％、84.21％、91.89％、85.71％、100％.结论:99Tcm-octreotide显像诊断嗜铬细胞瘤灵敏性、阴性预测值、准确性均低于131I-MIBG全身显像,两种方法诊断嗜铬细胞瘤准确性无一致性,99 Tcm-octreotide显像可作为嗜铬细胞瘤定位诊断方法的有效补充.%Objective:To evaluate application value of 99Tcm-octreotide imaging in diagnosis of pheochromocytoma.Methods:The data of 21 patients were diagnosis for pheochromocytoma by histopathological analysis as the experimental group.24 cases of hypertensive patients with urinary catecholamines, vanilla-based almond acid content were normal as control group.All lesions were confirmed by 131I-MIBG and 99Tcm-octreotide imaging.The ratio of tumor to normal tissue(T/NT) was calculated over ROI to observe the radioactive uptake.Comparison of the differences between 99Tcm-octreotide tumor receptor imaging and 131I-MIBG imaging in the sensitivity, specificity, accuracy, positive predictive value, negative predictive value.Results:The T/NT ratios were (3.24 ± 0.43) and (5.35 ± 0.32) in experiment group, respectively.(1.31 ± 0.18) and (1.26 ± 0.25) in control group, respectively.In the experimental group, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of the two methods for the diagnosis of pheochromocytoma were 83.33％,89.47％,86.48％,88.23％,85.00％ and 100％,84.21％, 91.89％, 85.71％, 100％, respectively.Conclusion:99 Tcm-octreotide imaging sensitivity, accuracy and negative predictive value were lower than 131I-MIBG imaging in diagnosis of pheochromocytoma, but 99Tcm-octreotide scintigraphy can be used as an effective complement on pheochromocytoma by conventional methods.