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目的 探讨乏氧显像剂99mTc -HL91(4 ,9-二氮 - 2 ,3,10 ,10 -四甲基十二烷 - 2 ,11-二酮肟 )显像探测鼻咽癌和转移淋巴结乏氧情况的价值。方法 对 5 0例确诊鼻咽癌 (未治疗 )和 10例对照组的患者进行鼻咽部和颈部99mTc -HL91乏氧断层显像 ,计算鼻咽和颈区发现的乏氧区与对侧对应部位 (T/A)感兴趣区 (ROI)的比值 ,并与同期的MR/CT相比较 ,最后经病理和临床确诊。结果 ① 4 3例MR/CT检查有明确的鼻咽肿物 (直径大小为 0 9～ 6 2cm)的鼻咽癌患者 ,以T/A >1 5为阳性 ,38例99mTc -HL91乏氧显像阳性 ,阳性率为 88 4 %。 2hT/A比值为 1 96± 0 38,4hT/A比值为 2 6 8± 0 4 9;5例乏氧显像阴性 ,3例肿物直径小于 1 1cm。共 35例患者发现咽旁或颈侧大小不等的乏氧区共 4 8处 ,乏氧区的T/A比值均 >1 2 ,最高达 3 2 ,均证实为淋巴结转移病灶。7例MR/CT未发现明确鼻咽肿物的鼻咽癌患者 ,99mTc -HL91乏氧显像鼻咽部均为阴性 ,3例发现颈侧乏氧区共 5处。② 10例正常对照组患者99mTc-HL91乏氧显像均为阴性 ,未见鼻咽部或颈侧乏氧区存在。结论 大多数鼻咽癌患者鼻咽肿物和转移淋巴结存在乏氧组织 ,99mTc -HL91乏氧显像对探测鼻咽癌和转移淋巴结的乏氧情况有实用价值。
Objective To investigate the diagnostic value of 99mTc -HL91 (4, 9-diazoxide-2, 3,10,10-tetramethyldodecane-2,11-dione oxime) imaging for the detection of nasopharyngeal carcinoma and metastatic lymph nodes The value of hypoxic conditions. Methods Fifty patients with nasopharyngeal carcinoma (untreated) and 10 controls were enrolled in the 99mTc-HL91 hypoxemic imaging of the nasopharynx and neck, and the hypoxic zone found in the nasopharynx and neck region was compared with the contralateral (T / A) region of interest (ROI) ratio, and with the same period of MR / CT compared to the final pathological and clinical diagnosis. Results ①There was a positive T / A> 15 in 43 cases of nasopharyngeal carcinoma with clear nasopharyngeal mass (diameter of 0 9 ~ 62 cm) by MR / CT, and 38 cases of 99mTc -HL91 hypoxia Like positive, the positive rate of 88 4%. 2hT / A ratio of 1 96 ± 0 38, 4hT / A ratio of 2 6 8 ± 0 4 9; 5 cases of hypoxia imaging negative, 3 cases of tumor diameter less than 1 1cm. A total of 48 hypopharyngeal or parathyroidal hypoxic areas were found in 35 cases. The T / A ratio of hypoxic area was> 1 2, up to 32, all confirmed as lymph node metastasis. Seven cases of nasopharyngeal carcinoma without definite nasopharyngeal tumor were found in MR / CT. The nasopharyngeal of 99m Tc -HL91 hypoxia imaging was negative, and in the three cases, there were 5 hypoxia zones in the neck. ② 10 cases of normal control group 99mTc-HL91 hypoxia imaging were negative, no nasopharyngeal or neck hypoxia exists. Conclusions Most nasopharyngeal carcinoma patients have hypoxia in nasopharyngeal and metastatic lymph nodes. 99mTc -HL91 hypoxia imaging has practical value in detecting hypoxia of nasopharyngeal carcinoma and metastatic lymph nodes.