Matsuno N, Kuyama J, Uchida Y, Minoshima S, Hatano O, Imai Y, Uno K
Department of Radiology, Chiba University School of Medicine.
Kaku Igaku. 1995 May;32(5):473-8.
We evaluated hilar uptake on 67Ga-citrate scintigraphy and correlated with hilar lymph node metastases in one-hundred seventeen cases (two-hundred thirty four hila) of bronchogenic carcinoma. Hilar uptake was classified into three grades independently on anterior and posterior chest views: no uptake (grade 0), uptake equal to that in the thoracic vertebrae (grade 1), uptake higher than that in the thoracic vertebrae (grade 2). If a summed grade of anterior and posterior view was larger than 3, hilar uptake was considered as positive. In forty-four cases (forty-nine hila) with hilar lymph node metastases, positive hilar uptake was found in ten cases (eleven hila), resulting in sensitivity of 22% based on cases and 23% based on hila. In seventy-three cases (one-hundred forty-six hila) without hilar lymph node metastases, positive hilar uptake was found in six cases (ten hila), resulting in specificity of 91% based on cases and 93% based on hila. In comparison to scintigraphic findings of unilaterally positive hilar uptake, findings of bilaterally positive hilar uptake showed significantly lower accuracy in determining presence of hilar lymph node metastases. No definite correlation between hilar uptake and histopathology or 67Ga-citrate uptake in a primary tumor was observed. The results indicate that usefulness of 67Ga-citrate scintigraphy is limited when evaluating hilar lymph node metastases in bronchogenic carcinoma.
我们评估了117例(234个肺门)支气管癌患者67Ga-柠檬酸盐闪烁显像的肺门摄取情况,并将其与肺门淋巴结转移情况进行关联分析。在前位和后位胸部影像上,肺门摄取情况被独立分为三个等级:无摄取(0级)、摄取程度与胸椎相同(1级)、摄取程度高于胸椎(2级)。如果前位和后位影像的总等级大于3,则认为肺门摄取为阳性。在44例(49个肺门)有肺门淋巴结转移的患者中,10例(11个肺门)发现肺门摄取阳性,基于病例的敏感性为22%,基于肺门的敏感性为23%。在73例(146个肺门)无肺门淋巴结转移的患者中,6例(10个肺门)发现肺门摄取阳性,基于病例的特异性为91%,基于肺门的特异性为93%。与单侧肺门摄取阳性的闪烁显像结果相比,双侧肺门摄取阳性的结果在判断肺门淋巴结转移的存在方面准确性显著较低。未观察到肺门摄取与组织病理学或原发肿瘤中67Ga-柠檬酸盐摄取之间存在明确关联。结果表明,在评估支气管癌的肺门淋巴结转移时,67Ga-柠檬酸盐闪烁显像的作用有限。