彩色多普勒超声与^(99)Tc^m核素SPECT显像对甲状腺结节良恶性的鉴别诊断价值  

Value of Color Doppler Ultrasonography and ^(99)Tc^m Radionuclide SPECT Imaging in Differential Diagnosis between Benign and Malignant Thyroid Nodules

作　　者：钟伟[1] 

机构地区：[1]内江市第一人民医院核医学科,四川内江641000

出　　处：《医学综述》2015年第12期2259-2261,共3页Medical Recapitulate

摘　　要：目的探讨彩色多普勒超声与锝99核素单光子发射计算机断层显像(99Tcm-SPECT)在甲状腺结节良恶性鉴别诊断中的应用价值。方法选择内江市第一人民医院2009年1月至2012年8月收治的1231例甲状腺结节患者,患者均进行术前彩色多普勒超声与99Tcm-SPECT显像检查,并与术后病理进行对比分析,探讨其对甲状腺结节良恶性鉴别诊断的意义。结果彩色多普勒超声检查对甲状腺结节诊断的灵敏度为68.1%,特异度为90.1%,阳性预测值为71.9%,阴性预测值为88.3%,准确度为84.6%;99Tcm-SPECT甲状腺显像时灵敏度为52.8%,特异度为90.6%,阳性预测值为88.8%,阴性预测值为82.7%,准确度为80.3%;两者联合应用时灵敏度为91.9%,特异度为98.4%,阳性预测值为95.6%,阴性预测值为97.0%,准确度为96.7%;两者联合应用时灵敏度、特异度、阳性预测值、阴性预测值及准确性均显著高于两者单独使用(P<0.01)。结论彩色多普勒超声与99Tcm-SPECT显像联合应用在甲状腺结节性质的鉴别诊断中均具有重要临床意义,能提高诊断的准确率。Objective To discuss the clinical value of color doppler ultrasonography and99 Tcmradionuclide single photon emission computed tomography（ SPECT） imaging in differential diagnosis between benign and malignant thyroid nodules. Methods A total of 1231 patients with thyroid nodules admitted in Neijiang First Hospital from Jan. 2009 to Aug. 2012 were selected as research objects,color doppler ultrasonography and99 Tcmradionuclide SPECT（^99Tc^m-SPECT） imaging were applied to all the patients before operation,detection results were compared with postoperative pathological results,and the significance of such detections in the differential diagnosis between benign and malignant thyroid nodules was explored. Results The detective sensitivity,specificity,positive predictive value,negative predictive value and accuracy of color doppler ultrasonography were 68. 1%,90. 1%,71. 9%,88. 3%,and 84. 6%,those of^99Tc^m-SPECT were 52. 8%,90. 6%,88. 8%,82. 7%,and 80. 3%,and those of combined detection of color doppler ultrasonography and^99Tc^m-SPECT were 91. 9%,98. 4%,95. 6%,97. 0%,and 96. 7%,which showed the sensitivity,specificity,positive predictive value,negative predictive value and accuracy of combined detection were significantly higher than those of either color doppler ultrasonography or^99Tc^m-SPECT detection（ P〈0. 01）. Conclusion Color doppler ultrasound combined with^99Tc^m-SPECT imaging has important clinical significance in the differential diagnosis of thyroid nodules,and it can improve the diagnostic accuracy.

关 键 词：甲状腺结节 彩色多普勒超声 99Tcm核素单光子发射计算机断层显像 鉴别诊断 

分 类 号：R817.4[医药卫生—影像医学与核医学]