^18F-FDGPET／CT对甲状腺结节性病变的诊断价值  

Diagnostic value of ^18F-FDG PET/CT in thyroid nodules

作　　者：徐继有[1] 于丽娟[1] 王文志[1] 陆佩欧[1] 王艳颖[1] 

机构地区：[1]哈尔滨医科大学附属第三医院PET/CT中心,150081

出　　处：《中华核医学与分子影像杂志》2013年第5期343-346,共4页Chinese Journal of Nuclear Medicine and Molecular Imaging

摘　　要：目的探讨^18F-FDGPET／CT显像对于甲状腺结节性病变的诊断价值。方法回顾性分析2008年1月至2012年5月^18F—FDGPET／CT检查发现甲状腺结节性病变并有病理结果的34例患者资料，其中男13例，女21例，年龄21～73（53．00±12．57）岁。选取20名2011年1月至2011年12月在PET／CT中心进行健康体格检查而甲状腺未发现异常者作为健康对照组，其中男9名，女11名，年龄40—55（45．00±4．72）岁。应用Wilcoxon秩和检验，分别对甲状腺良性病变和恶性病变组、良性病变和对照组及恶性病变和对照组的SUVmax进行分析，比较差异并对甲状腺结节长径行ROC曲线分析（AUC≥0．70为诊断准确性中～较高）。甲状腺结节出现局限性异常放射性浓聚，而CT示病灶边界不清，内部密度不均，有点状、小圆形或弧形钙化，或同时颈部出现异常放射性浓聚的肿大淋巴结，远处器官出现可疑转移瘤者，PET／CT诊断为恶性。计算PET／CT诊断甲状腺恶性结节的效能指标。结果（1）病理结果为恶性肿瘤18例，良性病变16例。甲状腺良、恶性组和健康对照组SUVmax分别为7．59±8．69、5．75±4．48和1．38±0．57。甲状腺良、恶性组SUVmax差异无统计学意义（X^2=0．207，P〉0．05），但两者与健康对照组比较差异均有统计学意义（H=3．408和3．553，均P〈0．01）。（2）甲状腺良、恶性组SUVmax的ROC分析，AUC为0．557（〈0．70），诊断准确性较低。（3）^18F-FDGPET／CT诊断甲状腺良、恶性结节的灵敏度、特异性、阳性预测值、阴性预测值和准确性分别为72．2％（13／18）、75．0％（12／16）、76．5％（13／17）、70．6％（12／17）和73．5％（25／34）。结论甲状腺结节单纯依据放射性摄取情况判断良恶性价值有限，但结合同机cT上的病灶形态学特点，^18F—FDGPET／CT可以初步推测其良恶性，为临床提供客观信息。【Objective To investigate the diagnostic value of 18F-FDG PET/CT for thyroid nodules. Methods From January 2008 to May 2012, 34 patients （ 13 males, 21 females; age range： 21-73 years, mean （53.00±12.57） years） with thyroid nodules on 18F-FDG PET/CT and with histopathological results were retrospectively analyzed. From January 2011 to December 2011, 20 cases （9 males, 11 females; age range： 40-55 years, mean （45.00±4.72） years） were selected as control group. Wilcoxon rank sum test and ROC analysis （AUC≥0.7 was considered the standard of medium-high accuracy） were used. PET/CT features taken to suggest malignant thyroid nodules were ： focally high uptake on PET, indistinct boundary or heterogeneous density on CT with punctuate, round or curved calcifications, or with hypermetabolic cervical lymph nodes as ancillary supportive findings of metastasis. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of PET/CT for diagnosing thyroid nodules were calculated. Results （1） There were 18 patients with malignant and 16 with benign thyroid nodules. The SUVmax of benign, malignant nodules and normal controls were 7.59±8.69, 5.75±4.48 and 1.38±0.57, respectively. The differences between malignant thyroid nodules and controls, between benign nodules and controls were signifi- cant （u = 3.553, 3.408, both P〈0.01 ）. There was no significant difference between benign and malignant thyroid nodules （ u = 0.207, P〉0.05 ）. （2） The AUC for the differentiation of benign and malignant thyroid nodules by ROC analysis was 0.557 （〈0.70）. （3） The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of JSF-FDG PET/CT for the differentiation of benign and malignant thyroid nodules were 72.2% （13/18）, 75.0% （12/16）, 76.5% （13/17）, 70.6% （12/17） and 73.5% （25/ 34）, respeetively. Conclusions lSF-FDG PET/CT has limited value for the differentiation between benign and malignant thy

关 键 词：1甲状腺结节 体层摄影术 发射型计算机 体层摄影术 X线计算机 脱氧葡萄糖 

分 类 号：R581[医药卫生—内分泌] R817.4[医药卫生—内科学] R816.6[医药卫生—临床医学]