⁹⁹Tc^m-MIBI乳腺专用伽玛显像在乳腺Paget病中的临床应用价值

Objective: To describe the features of technetium-99m methoxyisobutylisonitrile (⁹⁹Tc^m-MIBI) breast specific gamma imaging (BSGI)of breast Paget's disease (BPD) patients, and to investigate its value in clinical application. Methods: Seven patients with histologically proven BPD were collected, with an average age of 51.3 years. ⁹⁹Tc^m-MIBI BSGI, ultrasonography (US,n=7), mammography (MMG,n=6) and breast magnetic resonance imaging (MRI,n=4) were performed before the initial therapy. The clinical data and features of ⁹⁹Tc^m-MIBI BSGI were reviewed retrospectively to calculate the sensitivity of BSGI for BPD and concurrent breast cancer, and the results of US, MMG and MRI were compared. Results: In 7 BPD patients, BSGI detected 6 small round (n=5) or small lamellar (n=1) incremental radioactive uptake in nipple/skin lesions. Of them, 4 patients were considered as malignancy with a sensitivity of 57.1%. US detected subcutaneous hypoechoic area of left nipple in 1 patient with a sensitivity of 14.3%. In 6 patients underwent MMG, no nipple/skin lesions were found. In 4 patients underwent MRI, 2 nipple malignancy were found with a sensitivity of 50.0%. For 6 patients with concurrent breast cancer,the sensitivity of BSGI,US and MMG were all 66.7%,respectively, and the sensitivity of MRI was 50.0%. Conclusion: ⁹⁹Tc^m-MIBI imaging can detect malignant lesions of nipple/skin with proliferative activity in BPD, and provide important information for the diagnosis and treatment of BPD.