【作者】 葛永斌；

【导师】 徐浩；

【作者基本信息】 暨南大学 ， 影像医学与核医学， 2003， 硕士

【摘要】 [目的]： 评价¹³¹I-MIBG肾上腺髓质显像诊断儿茶酚胺增多症的临床价值，提高临床对¹³¹I-MIBG肾上腺髓质显像诊断价值的认识。 [方法]： 以1997-2002年在我院接受¹³¹I-MIBG肾上腺髓质显像检查的59例临床疑诊儿茶酚胺增多症患者作为研究对象。59例研究对象被分成两组：儿茶酚胺增多症组（24例）和非儿茶酚胺增多症组（35例）。24例儿茶酚胺增多症患者均由术后病理诊断证实；35例非儿茶酚胺增多症患者中，10例由术后病理诊断证实，25例由临床随访10个月以上证实。在59例研究对象中，接受X线计算机断层（CT）检查38例，超声（USG）检查38例，核磁共振（MRI）检查10例。对所有研究对象的四种影像学检查诊断结果进行回顾性比较分析，评价¹³¹I-MIBG显像的诊断效能。 [结果]： 1．¹³¹I-MIBG肾上腺髓质显像诊断儿茶酚胺增多症的灵敏度为95.8％，特异性为82.9％，准确率为88.1％；诊断PHEO和AMH的灵敏度分别为100％，92.3％。 2．USG、CT、MRI诊断儿茶酚胺增多症的灵敏度分别为72.7％，80.0％，80.0％，特异性为87.5％，77.8％，60.0％，准确率为78.9％，78.9％，70．0％； ’”’I－MIBG肾上腺髓质显 断儿莎酚肢增多症的临床价值诊断 PHEO的灵敏度分别为 SO刀％，71．4％，SO．O％；诊断 AMH的灵敏度分别为 81．8％，83．3％，SO刀％。 3．‘nI－MIBG显脚 CT、MRI、USG之间诊断)底酚胺增多症的灵敏度、特异性和准确率均无明显统计学差别仔＞O刀5入诊断AM H的胸度也无明显统计学差别(P＞O刀5＊‘”1－＊18G和＊T、＊m之间诊断PH＊O的胸度也无明显统计学差别（P＞O．05人’”‘I－MIBG和 USG之间诊断 PHEO的灵敏度有明显统计学差别（P＜0＊5）。 4．＊’I－MIBG显像鞭）搽酚胺增多症（朗 PHEO＋AMH）的正确率为23／24（95．8O）；CT为 10／ZO（SO．Oo）；USG为7／22（31．8o）；MRI为O／6（O％）。l结论］： ‘刀I－MIBG肾上腺魄腿像和MRI、CT、USG一样，都是诊断J搽酚胺增多症有价值的影像学方法，但其定性诊断价值高于CT、MRI、USG。更多还原

【Abstract】 To evaluate clinical value of 131I-MIBG adrenomedullary scintigraphy in diagnosing catecholaminemia. [Methods]For 59 patients with clinical findings suggestive of catecholaminemia, the results of imaging procedures, i.e. 131I meta-iodobenzylguanidine (MIBG) scintigraphy, computed tomography(CT), magnetic resonance imaging(MRI) and ultrasonography(USG) were reviewed. We laied stress on 131I MIBG scintigraphy . The final diagnosis of 24 patients with catecholaminemia were confirmed by operation and pathologic examination ; 10 of 35 cases without catecholaminemia were confirmed by operation , the other 25 cases without catecholaminemia were confirmed by clinical diagnosis. This is a retrospective comparison study. [Results]1. The diagnostic sensitivity, specificity and accuracy for catecholaminemia of 131I-MIBG scintigraphy was 95.8 %, 82.9%, 88.1%,respectively , sensitivity for pheochromocytoma (PHEO) was 100 %, sensitivity for adrenal medullary hyperplasia (AMH) was 92.3%.2. The diagnostic sensitivity, specificity and accuracy for catecholaminemia of CT was 80.0%, 77.8%, 78.9% , respectively; USG was 72.7%, 87.5%, 78.9% , respectively; MRI was 80.0%, 60.0%, 70.0% , respectively. The diagnostic sensitivity for PHEO of CT was 71.4%, USG was 50.0%, MRI was 50.0%. The diagnostic sensitivity for AMH of CT was 83.3%, USG was 81.8%, MRI was 50.0%.3. Between 131I-MIBG scintigraphy and CT, MRI, USG, there was no obvious statistical difference (P>0.05) in sensitivity, specificity and accuracy for diagnosing catecholaminemia and AMH. Between 131I-MIBG scintigraphy and CT, MRI , there was no obvious statistical difference(P>0.05) in sensitivity for diagnosing PHEO. Between 131I-MIBG scintigraphy and USG, there was obvious statistical difference (P<0.05) in sensitivity for diagnosing AMH.4. The rate of characteristic diagnosis for catecholaminemia correctly of 131I-MIBG scintigraphy, CT, MRI and USG was 23/24 (95.8%), 10/20 (50.0%) ,7/22 (31.8%) ,0/6 (0%).[Conclusion]131I-MIBG scintigraphy is the same valuable in diagnosing catecholaminemia as CT, MRI and USG , but 131I-MIBG is super than CT, MRI and USG in characteristic diagnosis for catecholaminemia.更多还原