SPECT/CT双时相减影法断层融合成像联合血清甲状旁腺激素水平诊断甲状腺后方结节来源  

SPECT/CT double phases substraction tomography fusion imaging combined with serum parathormone in diagnosis of origin of posterior thyroid nodules

作　　者：任炳秀[1] 蔡静[1] 江丽玲 乔玉旺帕 王学红[1] 朱高红[1] 

机构地区：[1]昆明医科大学第一附属医院核医学科,云南昆明650032

出　　处：《中国医学影像技术》2015年第11期1643-1647,共5页Chinese Journal of Medical Imaging Technology

摘　　要：目的评价99 Tc m-MIBI双时相减影SPECT/CT断层融合成像联合血清甲状旁腺激素(PTH)对甲状腺后方结节的鉴别诊断价值。方法 110例甲状腺后方占位患者接受99 Tc m-MIBI双时相减影法及SPECT/CT断层融合成像,并检测患者的血清PTH水平。结果 110例患者中,经病理确诊为甲状旁腺来源75例,血清PTH水平为(360.63±202.25)pg/ml,其中99 Tc m-MIBI双时相减影法联合SPECT/CT断层融合显像阳性71例(71/75,94.67%);可疑阳性为4例(4/75,5.33%),其中2例为甲状旁腺恶性肿瘤,2例为异位甲状旁腺伴部分腺瘤样变;35例非甲状旁腺来源病例中,血清PTH水平为(83.95±42.19)pg/ml,其中26例结节性甲状腺肿表现为可疑阳性,2例甲状腺乳头状癌、5例孤立性甲状腺肿及2例甲状腺髓样癌表现为阳性;甲状旁腺来源病变患者血清PTH水平明显高于非甲状旁腺来源肿瘤(P<0.01);结合患者PTH水平,双时相减影法诊断甲状腺后方结节为甲状旁腺来源的灵敏度约为94.67%(71/75)。结论 99 Tc m-MIBI双时相减影法联合SPECT/CT断层融合成像结合血清PTH水平诊断伴PTH升高的甲状腺后结节是否为甲状旁腺来源有较高价值。Objective To assess the value of double phases substraction tomography fusion imaging combined with serum parathormone（PTH）in differentiating origin of posterior thyroid nodules.Methods Totally 110 patients with posterior thyroid nodules underwent double phases substraction tomography fusion imaging,and PTH level were detected.ResultsSeventy-five of 110 patients were diagnosed as parathyroid sources by pathology with PTH level of（360.63 ±202.25）pg/ml,and 71 of the 75patients（71/75,94.67%）had positive imaging,4of the 75 patients were suspicious positive（4/75,5.33%）,including 2cases of malignant parathyroid tumors,2cases of ectopic parathyroid with partial adenomatous change.Thirty-five patients of 110 patients were diagnosed as non parathyroid source with the PTH level of（83.95±42.19）pg/ml,including 26 cases of nodular goiter with suspicious positive imaging,2cases of thyroid papillary carcinoma with positive imaging,5cases of solitary thyroid goiter with positive imaging and 2cases of medullary thyroid carcinoma with positive imaging.The statistical results showed that the serum PTH levels in patients with parathyroid lesions was significantly higher than that in non parathyroid tumors（P〈0.01）.Combined with the level of PTH in serum,double phases subtraction and tomography fusion imaging diagnosed posterior thyroid nodules as parathyroid derived with a sensitivity of approximately 94.67%（71/75）.Conclusion SPECT/CT double phases substraction tomography fusion imaging combined with serum PTH level has higher value in distinguishing whether posterior thyroid nodules from parathyroid or not.

关 键 词：99M锝甲氧基异丁基异腈 双时相减影法 断层融合成像 甲状旁腺肿瘤 甲状旁腺激素 

分 类 号：R817[医药卫生—影像医学与核医学] R736.2[医药卫生—放射医学]