Ishiyama Koichi, Tomura Noriaki, Okada Kyoji, Nagasawa Hiroyuki, Sashi Ryuji, Sasaki Kazufumi, Sato Kimihiko, Watarai Jiro
Department of Radiology, Akita University School of Medicine, Akita, Japan.
Clin Nucl Med. 2005 Sep;30(9):598-603. doi: 10.1097/01.rlu.0000174297.55863.d2.
The purpose of this study was to evaluate the use of radionuclide angiography and single photon emission computed tomography (SPECT) using Tc-99m hexakis-2-methoxyisobutylisonitrile (Tc-99m MIBI) for analyzing musculoskeletal lesions.
Radionuclide angiography and SPECT using Tc-99m MIBI were performed in 36 patients with various soft tissue and bone pathologies (18 benign and 18 malignant lesions). The ratio of the counts of the lesion to that of the contralateral normal area was calculated from the region of interest drawn on the MIBI scan. The MIBI-uptake ratio was calculated using SPECT and the MIBI-perfusion index was calculated using radionuclide angiography.
The MIBI-uptake ratio in malignant lesions (4.80 +/- 4.43) was significantly higher (P < 0.05) than that in benign lesions (1.83+/-2.48). The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of the MIBI-uptake ratio for malignant lesions were 72%, 83%, 78%, 81%, and 75%, respectively. The MIBI-perfusion index in malignant lesions (17.68 +/- 21.19) was significantly higher (P < 0.05) than that in benign lesions (2.25 +/- 2.56). The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of the MIBI-perfusion index for malignant lesions were 87%, 75%, 81%, 77%, and 86%, respectively.
The MIBI-uptake ratio and MIBI-perfusion index using Tc-99m MIBI can yield important additional information with which to differentiate musculoskeletal lesions.
本研究的目的是评估使用放射性核素血管造影和单光子发射计算机断层扫描（SPECT），利用锝-99m 六甲基异丁基异腈（Tc-99m MIBI）分析肌肉骨骼病变的情况。
对 36 例患有各种软组织和骨骼病变（18 例良性病变和 18 例恶性病变）的患者进行了使用 Tc-99m MIBI 的放射性核素血管造影和 SPECT。从 MIBI 扫描上绘制的感兴趣区域计算病变计数与对侧正常区域计数的比值。使用 SPECT 计算 MIBI 摄取率，使用放射性核素血管造影计算 MIBI 灌注指数。
恶性病变的 MIBI 摄取率（4.80±4.43）显著高于良性病变（1.83±2.48）（P<0.05）。MIBI 摄取率对恶性病变的敏感性、特异性、准确性、阳性预测值和阴性预测值分别为 72%、83%、78%、81%和 75%。恶性病变的 MIBI 灌注指数（17.68±21.19）显著高于良性病变（2.25±2.56）（P<0.05）。MIBI 灌注指数对恶性病变的敏感性、特异性、准确性、阳性预测值和阴性预测值分别为 87%、75%、81%、77%和 86%。
使用 Tc-99m MIBI 的 MIBI 摄取率和 MIBI 灌注指数可为鉴别肌肉骨骼病变提供重要的额外信息。
