Mulero F, Nicolás F, Castellón M I, Fuentes T, de la Cruz P, Roca V, Abad L, Nuño de La Rosa J A
Servicio de Medicina Nuclear. Hospital Universitario Virgen de la Arrixaca. Murcia.
Rev Esp Med Nucl. 2000 Sep;19(5):344-9.
Breast scintimammography with 99mTc-MIBI has proven to be a useful complement to mammography in the diagnosis of breast cancer in the female population. Although the mammography, along with a physical examination, is the backbone of breast cancer diagnosis, there are groups of patients in whom the mammography has an even lower specificity.
Our study has aimed to assess the usefulness of breast 99mTc-MIBI scintimammography in those situations in which the mammography was indeterminate, such as, in dense breasts, young females or breasts with architectural distortion after surgery or radiation therapy.
We studied 109 females with mammographically dense breasts, 8 young females under 30 and 24 patients who had undergone previous surgery or radiation therapy. All cases were studied to rule out breast cancer. Final diagnosis was established with excisional biopsy.
In dense breasts MIBI scintimammography sensitivity was 88% and the mammography one 81%. MIBI scintimammography specificity was 90% and the mammography 28%. In young females MIBI scintimammography sensitivity was 100% and the mammography 50%, MIBI scintimammography specificity 100% and the mammography 20%. In previous surgery, MIBI scintimammography sensitivity was 80% and the mammography 80%, MIBI scintimammography specificity 100% and the mammography 42%.
Breast scintimammography with 99mTc-MIBI is an excellent diagnostic technique with high specificity. Undoubtedly it is complementary to mammography in those cases where mammography has major limitations such as dense breasts, young females and breasts with severe scarring after surgery or radiation therapy.
用99mTc-MIBI进行乳腺闪烁显像已被证明是乳腺X线摄影在女性人群乳腺癌诊断中的有用补充。尽管乳腺X线摄影连同体格检查是乳腺癌诊断的支柱,但仍有一些患者群体,乳腺X线摄影在这些群体中的特异性更低。
我们的研究旨在评估乳腺99mTc-MIBI闪烁显像在乳腺X线摄影结果不确定的情况下的有用性,例如在乳腺致密、年轻女性或术后或放疗后出现结构扭曲的乳腺中。
我们研究了109例乳腺X线摄影显示乳腺致密的女性、8例30岁以下的年轻女性以及24例曾接受过手术或放疗的患者。所有病例均进行研究以排除乳腺癌。最终诊断通过切除活检确定。
在乳腺致密的患者中,MIBI乳腺闪烁显像的敏感性为88%,乳腺X线摄影为81%。MIBI乳腺闪烁显像的特异性为90%,乳腺X线摄影为28%。在年轻女性中,MIBI乳腺闪烁显像的敏感性为100%,乳腺X线摄影为50%,MIBI乳腺闪烁显像的特异性为100%,乳腺X线摄影为20%。在曾接受手术的患者中,MIBI乳腺闪烁显像敏感性为80%,乳腺X线摄影为80%,MIBI乳腺闪烁显像特异性为100%,乳腺X线摄影为42%。
用99mTc-MIBI进行乳腺闪烁显像是一种具有高特异性的优秀诊断技术。在乳腺X线摄影存在重大局限性的情况下,如乳腺致密、年轻女性以及术后或放疗后有严重瘢痕的乳腺,它无疑是乳腺X线摄影的补充。