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[延迟Tc-99m-吡哆醛-5'-甲基色氨酸显像在肝细胞癌特异性诊断中的应用]

[Delayed Tc-99m-PMT imaging in the specific diagnosis of hepatocellular carcinoma].

作者信息

Wu Z M

机构信息

Zhongshan Hospital, Shanghai University of Medical Sciences.

出版信息

Zhonghua Zhong Liu Za Zhi. 1988 Sep;10(5):360-3.

PMID:2854779
Abstract

The results of Tc-99m-PMT imaging on 100 patients with various malignant and benign hepatic diseases verified histologically (73 hepatocellular carcinoma, 3 liver cell adenoma, 1 cholangiocarcinoma, 5 metastatic liver carcinoma, 2 liver cyst, 12 hemangioma, 1 fatty degeneration, 1 liver regeneration, 1 postoperative liver fibrosis and 1 liver cirrhosis) are reported. All lesions appeared as decreased radioactivity or "cold" defect region on early Tc-99m-PMT imaging, rendering it valuable for the diagnosis of tumor localization. In 92 (95.8%) of the 96 patients with various hepatic tumors and 25 (86.2%) of the 29 patients with small hepatocellular carcinoma (less than 5 cm), the tumors were localized by early Tc-99m-PMT imaging. In 14 of the 73 patients with established hepatocellular carcinoma, the tumors gave greater radioactivity than that of the surrounding liver tissues, whereas in 31 patients the radioactivity of the tumor equalled the normal liver on delayed Tc-99m-PMT imaging (positive rate 61.6%). There was no significant difference between the positive rates of serum AFP level and the tumor size shown by delayed Tc-99m-PMT imaging in hepatocellular carcinomas. The radioactivity in 3 liver cell adenoma patients was similar to the gallbladder. No false positive result was seen in the other malignant and benign hepatic tumors. This study indicates that delayed Tc-99m-PMT imaging is highly specific in the diagnosis of hepatocellular carcinoma.

摘要

报告了对100例经组织学证实的各种恶性和良性肝脏疾病患者(73例肝细胞癌、3例肝腺瘤、1例胆管癌、5例转移性肝癌、2例肝囊肿、12例血管瘤、1例脂肪变性、1例肝再生、1例术后肝纤维化和1例肝硬化)进行的锝-99m-吡哆醛-5-甲基色氨酸(Tc-99m-PMT)显像结果。所有病变在早期Tc-99m-PMT显像上均表现为放射性减低或“冷”缺损区,这使其对肿瘤定位诊断具有价值。在96例各种肝脏肿瘤患者中的92例(95.8%)以及29例小肝细胞癌(小于5 cm)患者中的25例(86.2%),通过早期Tc-99m-PMT显像可对肿瘤进行定位。在73例确诊的肝细胞癌患者中,有14例肿瘤在延迟Tc-99m-PMT显像上的放射性高于周围肝组织,而在31例患者中肿瘤的放射性与正常肝脏相等(阳性率61.6%)。肝细胞癌患者中血清甲胎蛋白(AFP)水平阳性率与延迟Tc-99m-PMT显像所示肿瘤大小之间无显著差异。3例肝腺瘤患者的放射性与胆囊相似。在其他恶性和良性肝脏肿瘤中未出现假阳性结果。本研究表明,延迟Tc-99m-PMT显像在肝细胞癌诊断中具有高度特异性。

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