Zhang Ye, Guo Chuan-Bin, Yu Guang-Yan, Ma Da-Quan, Li Qian, Zhang Chun-Li
Department of Oral and Maxillofacial Surgery, Peking University School of Stomatology, Beijing 100081, China.
Zhonghua Er Bi Yan Hou Ke Za Zhi. 2004 Jul;39(7):425-8.
To evaluate the applicability of 99mTc(V) -dimercaptosuccinic acid (99mTc (V) -DMSA) imaging in detecting neck metastases in patients with oral squamous cell carcinoma.
Single photon emission computer tomography (SPECT) scintigraphy with 99mTc(V) -DMSA was performed on 32 patients with primary squamous cell carcinoma in oral cavity. The coronal aspect of SPECT image was chosen, the region of interest (ROI) of the affected neck was drawn, and the radioactivity uptake value of the ROI was given by the computer to compare with the contralateral neck. The results of 99mTc(V) -DMSA were compared with postoperative pathological studies. For false positive lymph nodes, semi-continuous slice was carried out for pathology examination.
The sensitivity, specificity and accuracy of 99mTc(V) -DMSA imaging for detecting metastatic lymph nodes were 75.0%, 90.0% and 84.4% respectively. The ROI values of the affected neck are higher than that of the contralateral part in the 9 positive patients (t = 8.128, P = 0.000 04). Metastasis was not found in the enlarged lymph nodes of the false positive patients.
99mTc(V) -DMSA SPECT imaging has fairly high affinity with metastatic lymph nodes in the neck especially in the cN0 patients and is helpful for designing proper neck dissection.
评估99m锝（V）-二巯基丁二酸（99mTc（V）-DMSA）显像在检测口腔鳞状细胞癌患者颈部转移瘤中的应用价值。
对32例口腔原发性鳞状细胞癌患者进行99mTc（V）-DMSA单光子发射计算机断层扫描（SPECT）显像。选取SPECT图像的冠状位，绘制患侧颈部的感兴趣区（ROI），由计算机给出ROI的放射性摄取值，并与对侧颈部进行比较。将99mTc（V）-DMSA的检查结果与术后病理研究结果进行比较。对于假阳性淋巴结，进行半连续切片病理检查。
99mTc（V）-DMSA显像检测转移性淋巴结的灵敏度、特异度和准确度分别为75.0%、90.0%和84.4%。9例阳性患者患侧颈部的ROI值高于对侧（t = 8.128，P = 0.000 04）。假阳性患者肿大淋巴结未发现转移。
99mTc（V）-DMSA SPECT显像对颈部转移性淋巴结尤其是cN0患者具有较高的亲和力，有助于设计合适的颈部清扫术。
