Histologic and Hydrodynamic Evaluation of Blood Flow for Scintigraphic Detection of Malignant Tumor of the Head and Neck.

在动物实验中，对日本大白兔股骨右区VX2癌移植进行组织学、血管造影和血流动力学检查。超声血流量仪（5 MHz）测得肿瘤侧右股动脉血流速率和血流量约为对照侧（左股动脉）的2 ~ 3倍，肿瘤血管随肿瘤生长而丰富。在临床检查中，对117例口腔癌患者进行了影像学和组织病理学检查。在给予<@D199m@>D1Tc-HMDP后立即用显像估计肿瘤血流量。观察静脉期（给药后30 ~ 40秒）和血池期（给药后1 ~ 3分钟）的放射性。计算两期肿瘤对对照区的放射性比值；静脉比（VR）、血池比（BPR）。给药后5分钟获得含有<@D199m@>D1Tc-HMDP的早期图像（早期图像），给药后3天获得含有<@D167@>D1Ga-citrate的图像（Ga-image）。组织病理学上将肿瘤血管形态分为三组；富人、中等收入者和穷人。VR、BPR、早期影像、ga影像、血管形态、肿瘤大小相互比较。可怜的血管模式显示小VR (M (SY。+ -。(SD) = 0.97 (SY。+ -。(0.08)和BPR (1.02 (SY。+ -。[)0.04)。血管形态丰富，VR大（1.39(]SY.+- . [)0.01）， BPR大（1.31(]SY.+- .[)0.16）。大VR（78%）和BPR（100%）早期阳性影像居多。小于3cm的肿瘤65%为中、富血管型，早期阳性图像反映肿瘤血流。这些结果表明将早期图像（血流图像）与延迟图像相结合可以提高检测率。

In the experiment with animals, Japan white rabbits transplanted with VX2 carcinoma in the right femoral regionwere examined histologically, angiographically and hydrodynamically. The tumor blood vessel became rich in accordance with tumor growth and the blood flow rate and the volume of the blood flow of the right femoral artery in the tumor side was approximately twice or three times as much as that in the control side (left femoral artery) by means of the ultrasonic blood flow meter (5 MHz). In the clinical examination, 117 patients with oral cancer were examined scintigraphically and histopathologically. Tumor blood flow was estimated scintigraphically immediately after administration of <@D199m@>D1Tc-HMDP.Radioactivity of venous phase (30 to 40 seconds after administration) and blood pool phase (1 to 3 minutes) were observed. Radioactive ratios of tumor to the control region in both phases were calculated ; venous ratio (VR), blood pool ratio (BPR). Early image with <@D199m@>D1Tc-HMDP (early image) was obtained 5 minutes after administration and the image with <@D167@>D1Ga-citrate (Ga-image) was obtained 3 days after administration. Tumor vascular patterns were classified histopathologically into three groups ; rich, intermediate and poor. VR,BPR,early image, Ga-image, vascular pattern and tumor size were compared each other. Poor vascular pattern showed small VR (M(]SY.+-。[)SD=0.97(]SY.+-。[)0.08) and BPR (1.02(]SY.+-。[)0.04). Rich vascular pattern showed large VR (1.39(]SY.+-。[)0.01) and BPR (1.31(]SY.+-。[)0.16). Positive early image was predominant among large VR (78%) and BPR (100%). Tumors of under 3 cm in size showed that 65% of them belonged to intermediate or rich vascular pattern and positive early image reflected tumor blood flow. These results intimated the improvement of detecting ratio by combining early image (blood flow image) with delayd image.