放射性核素出血显像在消化道出血诊断中的临床应用价值
Clinical application value of radionuclide bleeding scintigraphy in the diagnosis of gastrointestinal bleeding
王巍 1王观筠 1阚英 1刘洁 1张抒欣 1杨吉刚1
作者信息
- 1. 首都医科大学附属北京友谊医院核医学科 北京 100050
- 折叠
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(99mTc-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99mTc-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99mTc-RBC平面显像与99mTc-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99mTc-RBC平面显像与99mTc-RBC SPECT/CT的诊断效能.结果 99mTc-RBC SPECT/CT断层显像检测的出血检出率为52.3％,高于99mTc-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,99mTc-RBC SPECT/CT断层显像的诊断准确率为90.7％,高于99mTc-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,99mTc-RBC SPECT/CT断层显像的诊断准确率为100.0％,显著高于99mTc-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,99mTc-RBC SPECT/CT断层显像的诊断准确率为100.0％,高于99mTc-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,99mTc-RBC SPECT/CT断层显像较99mTc-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.
Abstract
Objective To investigate the clinical value and factors influencing 99m Technetium labelled red blood cells single-photon e-mission 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 99mTc-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 99mTc-RBC bleeding imaging.Intermittent static scans were performed until the planar imaging at the sixth hour,local SPECT/CT imaging was con-ducted when suspicious positivity was detected.If no significant positive findings were found,the CT soan was delayed until sixth hour.The detec-tion rate and diagnostic accuracy of 99mTc-RBC planar imaging and 99mTc-RBC SPECT/CT tomography imaging were analyzed;the"gold stand-ard"was used as a reference,the diagnostic efficacy of 99mTc-RBC planar imaging and 99mTc-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 99mTc-RBC planar imaging(33.7％),and the difference was statistically significant(P＜0.05).Compared with the"gold standard",the diagnostic accuracy of 99mTc-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 pa-tients,the diagnostic accuracy of 99m Tc-RBC SPECT/CT tomography was 100.0％,which was significantly higher than that of 99mTc-RBC pla-nar 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 low-er gastrointestinal bleeding,the diagnostic accuracy of 99mTc-RBC SPECT/CT tomography was 100.0％,which was higher than that of 99mTc-RBC planar imaging(64.3％),and the difference was statistically significant(P＜0.05).Conclusion Radionuclide imaging helps to deter-mine the cause and location of gastrointestinal bleeding.99m Tc-RBC SPECT/CT tomography has higher diagnostic efficacy than 99m Tc-RBC pla-nar imaging,which can provide accurate guidance for the diagnosis and treatment of gastrointestinal bleeding.
关键词
放射性核素显像/诊断/消化道出血/99mTc-RBC/单光子发射计算机断层扫描/计算机断层扫描Key words
Radionuclide imaging/Diagnosis/Gastrointestinal bleeding/99mTc-RBC/SPECT/CT引用本文复制引用
出版年
2024
NETL
NSTL
万方数据