摘要
目的 探讨放射性核素99m锝红细胞单光子发射型计算机断层显像(^(99m)Tc-RBC SPECT/CT)在诊断消化道出血中的临床价值。方法 回顾性选取2019年1月至2023年2月首都医科大学附属北京友谊医院核医学科收治的86例临床怀疑为消化道出血并行^(99m)Tc-RBC SPECT/CT出血显像的患者。所有患者均行体内法标记,间断静态扫描至6 h平面显像,扫描过程中发现可疑阳性时立即行局部SPECT/CT显像;如无明显阳性发现,则延迟至6 h行断层显像。分析^(99m)Tc-RBC平面显像与^(99m)Tc-RBC SPECT/CT断层显像的检出率、诊断准确率;以“金标准”为参照,比较不同部位^(99m)Tc-RBC平面显像与^(99m)Tc-RBC SPECT/CT的诊断效能。结果^(99m)Tc-RBC SPECT/CT断层显像检测的出血检出率为52.3%,高于^(99m)Tc-RBC平面显像(33.7%),差异有统计学意义(P<0.05)。与“金标准”进行参照,^(99m)Tc-RBC SPECT/CT断层显像的诊断准确率为90.7%,高于^(99m)Tc-RBC平面显像(73.3%),差异有统计学意义(P<0.05)。在20例怀疑上消化道出血的患者中,^(99m)Tc-RBC SPECT/CT断层显像的诊断准确率为100.0%,显著高于^(99m)Tc-RBC平面显像(55.0%),差异有统计学意义(P<0.05)。在25例怀疑中消化道出血的患者中,两种诊断方法之间的诊断效能比较,差异无统计学意义(P>0.05)。在14例下消化道出血的患者中,^(99m)Tc-RBC SPECT/CT断层显像的诊断准确率为100.0%,高于^(99m)Tc-RBC平面显像(64.3%),差异有统计学意义(P<0.05)。结论 放射性核素显像有助于消化道出血原因及部位判断,^(99m)Tc-RBC SPECT/CT断层显像较^(99m)Tc-RBC平面显像具有更高的诊断效能,能为精准地指导消化道出血的诊断和治疗提高支持。
Objective To investigate the clinical value and factors influencing ^(99m)Technetium labelled red blood cells single-photon emission computed tomography/computed tomography(^(99m)Tc-RBC SPECT/CT)imaging with radioactive nuclide in gastrointestinal bleeding.Methods A total of 86 patients diagnosed with gastrointestinal bleeding and undergoing ^(99m)Tc-RBC SPECT/CT bleeding imaging selected from Beijing Friendship Hospital,Capital Medical University between January 2019 and February 2023 were selected.All patients received in vivo ^(99m)Tc-RBC bleeding imaging.Intermittent static scans were performed until the planar imaging at the sixth hour,local SPECT/CT imaging was conducted when suspicious positivity was detected.If no significant positive findings were found,the CT soan was delayed until sixth hour.The detection rate and diagnostic accuracy of ^(99m)Tc-RBC planar imaging and ^(99m)Tc-RBC SPECT/CT tomography imaging were analyzed;the"gold standard"was used as a reference,the diagnostic efficacy of ^(99m)Tc-RBC planar imaging and ^(99m)Tc-RBC SPECT/CT for gastrointestinal bleeding in different areas was compared.Results The bleeding detection rate detected by ^(99m)Tc-RBC SPECT/CT tomography imaging was 52.3%,which was higher than that of ^(99m)Tc-RBC planar imaging(33.7%),and the difference was statistically significant(P<0.05).Compared with the"gold standard",the diagnostic accuracy of ^(99m)Tc-RBC SPECT/CT tomography imaging was 90.7%,which was higher than that of ^(99m)Tc-RBC planar imaging(73.3%),and the difference was statistically significant(P<0.05).Among 20 suspected upper gastrointestinal bleeding patients,the diagnostic accuracy of ^(99m)Tc-RBC SPECT/CT tomography was 100.0%,which was significantly higher than that of ^(99m)Tc-RBC planar imaging(55.0%),and the difference was statistically significant(P<0.05).Among 25 suspected patients with gastrointestinal bleeding,there was no statistically significant difference in diagnostic efficacy between the two diagnostic methods(P>0.05).Among 14 patients with lower gastrointestinal bleeding,the diagnostic accuracy of ^(99m)Tc-RBC SPECT/CT tomography was 100.0%,which was higher than that of ^(99m)Tc-RBC planar imaging(64.3%),and the difference was statistically significant(P<0.05).Conclusion Radionuclide imaging helps to determine the cause and location of gastrointestinal bleeding.^(99m)Tc-RBC SPECT/CT tomography has higher diagnostic efficacy than ^(99m)Tc-RBC planar imaging,which can provide accurate guidance for the diagnosis and treatment of gastrointestinal bleeding.
作者
王巍
王观筠
阚英
刘洁
张抒欣
杨吉刚
WANG Wei;WANG Guan-yun;KAN Ying(Department of Nuclear Medicine,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)
出处
《临床和实验医学杂志》
2024年第11期1203-1207,共5页
Journal of Clinical and Experimental Medicine
基金
国家自然科学基金(编号:82102088)。
