99Tcm—MIBI显像联合超声鉴别诊断甲状腺结节良恶性的临床研究  

99Tcm-MIBI imaging combined with ultrasonography to identify benign and malignant thyroid nodules

作　　者：马春旭[1] 袁卫红[1] 赵艳花[1] 杨洪文[1] 刘平[1] 袁荣国[1] 黄淏[1] 马志祥[1] 

机构地区：[1]成都军区昆明总医院核医学科,650032

出　　处：《中华核医学与分子影像杂志》2016年第4期326-329,共4页Chinese Journal of Nuclear Medicine and Molecular Imaging

摘　　要：目的评价99Tcm－MIBI显像联合超声诊断对甲状腺结节良恶性的鉴别诊断价值。方法对2011年10月至2013年10月间超声证实为单发非囊性结节、99TcmO4－静态显像提示为甲状腺单发＂冷＂或＂凉＂结节、甲状腺功能正常、1周内行99Tcm－MIBI亲肿瘤显像且经手术取得病理结果的76例患者[男18例，女58例，平均年龄（45.34±12.74）岁]资料进行回顾性研究。99Tcm－MIBI显像行早期（15 min）和延迟（120 min）双时相采集。采用McNemar配对χ2检验比较99Tcm－MIBI亲肿瘤显像、超声检查及二者联合检查对良恶性甲状腺结节的鉴别诊断效能。结果99Tcm－MIBI双时相显像、超声和联合诊断对良恶性甲状腺结节诊断的灵敏度分别为55.56%（10/18）、72.22%（13/18）和88.89%（16/18），特异性分别为81.03%（47/58）、79.31%（46/58）和91.38%（53/58），准确性分别为75.00%（57/76）、77.63%（59/76）和90.79%（69/76）。联合诊断优于99Tcm－MIBI双时相显像和超声诊断（χ2＝5.79、8.64，均P〈0.05），99Tcm－MIBI双时相显像与超声诊断无明显差别。 结论99Tcm－MIBI双时相显像联合超声诊断能显著提高对良恶性甲状腺结节的鉴别诊断效能，具有较高的临床价值。Objective To evaluate the clinical value of the combined diagnosis of 99Tcm-MIBI ima- ging and ultrasonography on differentiating the benign and malignant thyroid nodules. Methods A total of 76 patients （ 18 males, 58 females, mean age： （45.34＋ 12.74） years） from October 2011 to October 2013 were enrolled in this retrospective study. All patients had solitary non-cystic nodules and normal thyroid function, and underwent 99TcmO4- static imaging, 99Tcm-MIBI imaging and pathological examination. 99Tcm- MIBI imaging included early phase （ 15 min） and delay phase （ 120 rain）. McNemar paired X2 test was used to compare the efficiency of 99Tcm-MIBI double phase imaging, ultrasonography and the combined diag- nosis on differentiating the benign and malignant thyroid nodules. Results The diagnostic values of 99Tcm- MIBI double-phase imaging, ultrasonography examination and the combined diagnosis were 55.56% （10/ 18）, 72.22%（13/18） and 88.89%（16/18） （for sensitivity）, 81.03%（47/58）, 79.31%（46/58） and 91.38% （53/58） （ for specificity） , and 75.00% （57/76） , 77.63% （59/76） and 90.79% （69/76） （ for ac- curacy） , respectively. The diagnosis efficiency of the combined diagnosis was better than that of 99Tcm-MIBI imaging or ultrasonography examination （X2= 5.79, 8.64, both P〈0.05）. There were no significant differ- ences between 99Tcm-MIBI imaging and ultrasonography examination. Conclusion 99 Tem_MIBI double- phase imaging combined with ultrasonography could obviously improve the diagnostic efficiency on the differ- entiation of benign and malignant thyroid nodules.

关 键 词：甲状腺结节 放射性核素显像 超声检查 诊断 鉴别 MIBI 

分 类 号：R736.1[医药卫生—肿瘤] R730.44[医药卫生—临床医学] R445.1