دور التصوير الومضاني بالـ 99mTc-Sestamibi في تحديد النوع النسيجي لسرطان الخلية الكبدية
Abstract
تمت دراسة 32 آفة سرطانية في 30 مريضاً بسرطان الخلية الكبدية بوساطة التصوير الومضاني باستخدام العقار المشع 99mTc-MIBI والكاميرا الغامية (سوف نشير للعقار المشع اختصاراً بـ الميبي المشع) لتقييم أنموذج التثبيت للعقار المشع في الآفات وعلاقته بالأنموذج النسيجي لسرطان الخلية الكبدية. تم تشخيص كل الآفات بوساطة الخزعة المأخوذة عبر الجلد. أظهر التصوير الومضاني زيادة تثبيت الميبي المشع في 14 آفة ونقصاً للتثبيت في 18 آفة. كل الآفات التي أظهرت زيادة في التثبيت للعقار المشع كانت من النوع المسمط (Compact). من بين الآفات التي أظهرت نقصاً في تثبيت العقار المشع، 17 آفة كانت من النوع التربيقي (Trabecular) بينما أظهرت آفة واحدة (ناقصة التثبيت للميبي المشع : ورم متنخر) أنها من النوع المسمط. تقترح هذه النتائج أن أنموذج التثبيت للميبي المشع في سرطان الخلية الكبدية يقسم إلى أنموذجين إيجابي وسلبي وتتوافق هذه الأشكال من التثبيت مع البناء النسيجي لسرطان الخلية الكبدية.
32 lesions in 30 patients with Hepatocellular carcinoma (HCC) were studied using gamma camera and technetium-99m metoxyisobutylisonitrile (99mTc-MIBI) to evaluate the pattern of uptake of 99mTc-MIBI in the lesions and the relationship between the uptake pattern and histopathology of HCC. All lesions were diagnosed as HCC by percutaneous needle biopsy. 14 of 32 lesions showed positive uptake of 99mTc-MIBI, while the other 18 showed negative uptake. All of the lesions which showed positive uptake were of the compact type. Of the 18 lesions that showed negative uptake, 17 were of the trabecular type while one was of the compact type (necrotic compact tumor). These results suggest that the pattern of 99mTc-MIBI accumulation in HCC is divided into positive and negative types and those uptake patterns are corresponded to tissue structure of HCC.
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