鎝—99m標幟藥劑與MOVA技術在前哨淋巴結定位之應用

背景：自Cabanas於1977年首先提出前哨淋巴結的觀念後，閃爍淋巴攝影技術不斷開發、改進，包括造影藥物、注射方法、造影時間與相位等。本科原使用鎝-99m-Nanocolloid藥物面臨停產。本研究評估以鎝-99m－Phytate替代，同時在造影相位中運用MOVA(modified obliqueview of the axilla)技術之可行性。方法：本研究共分藥物鎝-99m-Nanocolloid的35例（第一组）與藥物鎝-99m-Phytate加上MOVA相位輔助的25例（第二组），探討前哨淋巴結核醫造影於藥物的改變、造影相位技術的改善及造影時間點的運用，分析其對臨床偵测率的影響。結果：第一组偵測率爲88％，第二组爲96％。討論：結果顯示鎝-99m-Phytate能有效停留在前哨淋巴結，不會因爲顆粒較大而在造影顯像時間上與鎝-99m-Nanocolloid有顯著差異(P=0.45)。在造影相位方面，利用MOVA可以將腋窩的前哨淋巴結(AX sentinel node)有效地分開。藥物鎝-99m-Phytate與MOVA技術的輔助，能取代現有藥物鎝-99m-Nanocolloid，並减少成本的支出。

關鍵字

前哨淋巴結；閃爍淋巴攝影；鎝—99m—Phytate ； MOVA

並列摘要

Background: The concept of sentinel lymph node was firstly proposed by Cabanas in 1977. In this study of sentinel lymph node location, we attempted to investigate the influences of using different radiopharmaceuticals, the ways of injection, the length of image collecting time, and projection. Methods: 99mTc-Nanacolloid was applied in 35 cases (Group I), whereas 99mTc-phytate was applied in 25 cases (Group II) with MOVA (modified oblique view of the axilla) technique. Results: Our results showed the detection rate of sentinel lymph node was 88% and 96% in Group I and Group II, respectively. Conclusion: Although with a bigger molecular size, 99mTc-phytate appeared to be able to effectively retain in the sentinel lymph node and the length of image collecting time were no difference from 99mTc-Nanacolloid (P = 0.45). Also, with the assistance of MOVA image collection, sentinel lymph node which is close to the axilla can be more easily differentiated. Use of 99mTc-phytate with the assistance of MOVA techniques in the detection of sentinel lymph node not only provides a shorter examining time, but also keep the cost down.

並列關鍵字

sentinel lymph node ； lymphoscintigraphy ； 99mTc-Phytate ； MOVA

國際替代計量

鎝—99m標幟藥劑與MOVA技術在前哨淋巴結定位之應用

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