目的 選擇合適的複查時間，以提高99mTc –MIBI腦顯像對腦腫瘤立體定向適形放療療效的隨訪價值。方法 腦腫瘤患者59例，立體定向適形放療前1周及治療後10個月內進行99mTc-MIBI 腦SPECT顯像。以各複查時間點病例為一組，計算99mTc-MIBI 腦顯像在各組的靈敏度、特異性，診斷指標在各組間的差異用u檢驗。結果 治療前檢查靈敏度為86.4%（51/59）；治療後22例病灶消失，其餘37例患者腫瘤殘餘或復發，99mTc-MIBI 腦顯像檢查靈敏度81.1%（30/37），特異性63.6%（14/22），診斷準確度74.6%。治療後各個複查時間點之間比較，靈敏度未見顯著性差異；5.8個月複查特異性顯著高於治療後1個月（u=1.9735，P<0.05）及3個月（u=2.0728，P<0.05），而與9個月比較則無顯著性差異（u=1.4292，P>0.05）。結論 用99mTc –MIBI腦SPECT隨訪腦腫瘤立體定向適形放療的療效，治療後半年複查可獲得最佳診斷效果。
Fan Yixiang1, Peng Wuhe1,
1Department of Nuclear Medicine, Nanfang Hospital, First Military Medical University, Guangzhou 510515, China
2Department of Radiation Oncology, Guangzhou General hospital of Guangzhou Military Region, Guangzhou 510010, China
Objective To evaluate the therapeutic effects of radiosurgery on brain tumor using 99mTc _MIBI brain SPECT and select the optimal reassessment time point after radiosurgery. Methods 59 patients with brain tumor underwent 99mTc-MIBI brain SPECT within one week prior to and within 10 months after radiosurgery. All cases were divided into 4 groups according to different reassessment time after treatment. Diagnostic indices such as sensitivity, specificity and accuracy were calculated and compared between different groups by u-test. Results Before treatment, the sensitivity of 99mTc-MIBI SPECT was 86.4%(51/59); after treatment lesions disappearance occurred in 22 cases, focus remained or recured in 37 cases; its sensitivity and specificity were 81.1%(30/37) and 63.6%(14/22), respectively. Sensitivity showed no significant difference between each group; the specificity at 5.8 months was significantly higher than that at one month (u=1.9735,P<0.05) and 3.1 months (u=2.0728,P<0.05), but without significant difference when compared with that at 9.4 months (u=1.4292,P>0.05). Conclusions At 5.8 months after radiosurgery, 99mTc-MIBI brain SPECT can obtain favorable diagnostic effects. For follow-up survey of therapeutic effects of radiosurgery on brain tumor, the optimal reexamination time point is at about half a year after treatment.
Key Words: Brain tumor; 99mTc-MIBI; ECT; Radiosurgery; Therapeutic effect
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