^99Tc^m-HL91乏氧显像在甲状腺结节良恶性鉴别诊断中的应用  

Clinical application of ^99Tc^m-HL91 hypoxic imaging in differential diagnoses of malignancy from benign thyroid nodules

作　　者：谢新立[1] 韩星敏[1] 阮翘[1] 程兵[1] 刘保平[1] 

机构地区：[1]郑州大学第一附属医院核医学科,450052

出　　处：《中华核医学杂志》2008年第2期103-105,共3页Chinese Journal of Nuclear Medicine

基　　金：2002年度河南省科技厅科技攻关项目（0223034400）

摘　　要：目的评价^99Tc^m-4，9一二氮-3，3，10，10-四甲基十二烷-2，11-二酮肟（HL91）对甲状腺结节良恶性鉴别诊断的临床价值。方法对58例经触诊或超声检查存在甲状腺结节的患者进行^99Tc^m-HL91甲状腺早期（10min）及延迟（4h）平面显像，应用感兴趣区（ROI）技术计算靶／非靶（T／N）比值并进行比较。组间比较采用成组设计两样本均数t检验，率的比较用χ2检验。结果患者均经手术或细针穿刺病理检查，其中21例为甲状腺癌，37例为甲状腺良性结节。^99Tc^m-HL91显像诊断甲状腺癌的灵敏度、特异性和准确性分别为85．7％，94．6％和91．4％，不同甲状腺癌病理类型的显像灵敏度差异无统计学意义（χ2=0．778，P〉0．05），但结节越大灵敏度越高。甲状腺癌与甲状腺良性结节组早期及延迟相T／N比值分别为1．07±0．04，1．25±0．03和0．92±0．10，0．91±0．12，组间在10min时T／N比值差异无统计学意义（t=1．900，P〉0．05），4h时T／N比值差异有统计学意义（t=3．885，P〈0．001）。结论用^99Tc^m-HL91乏氧显像判断甲状腺结节的良恶性有一定的临床价值，显像时间以4h为佳。Objective Recent studies showed that ^99Tc^m-4,9-diaza-3,3,10,10-tetramethyldodeean-2,11-dizone dioxime （HL91） might be of potential in characterizing hypoxie areas within malignant tumors. The aims of this study were to use ^99Tc^m-HL91 in patients with thyroid nodules and also to explore its clinical utilities in differentiate benign and malignant thyroid nodules. Methods Fifty-eight patients with thyroid nodules, detected either by ultrasound or physical palpation, were enrolled. ^99Tc^m-HLgl planar thyroid images were performed at early （ 10 min after injection） and delay （4 h after injection） phases. The radioactivity ratio of tumor to non-tumor （T/N） was calculated and compared with the pathological results. The t test and χ2 test were used for data analysis. Results Of the 58 patients, 21 were thyroid cancer and 37 were benign nodules. The sensitivity, specificity and accuracy of ^99Tc^m-HL91 for thyroid cancer were 85.7%, 94.6% and 91.4% respectively. Moreover, the sensitivity was positively correlated with the tumor size and was unrelated to the histological types （χ2 = 0. 778, P〉0.05 ）. A significant higher uptake of ^99Tc^m-HL91 in malignant nodule was noted than benign at delay phase （1.25±0.03 vs 0.91 ±0.12, t=3. 885, P 〈0. 001 ）. Conclusion ^99Tc^m-HL91 hypoxic imaging has potential in both detecting and differentiating malignancy from benign thyroid nodules, especially when delay phase was applied.

关 键 词：甲状腺结节 诊断 鉴别 放射性核素显像 HL91 

分 类 号：R686[医药卫生—骨科学]