^99Tc^m-MIBI SPECT/CT诊断甲状腺乳头状癌术后彩色多普勒超声疑似颈部淋巴结转移  

^99Tc^m-MIBI SPECT/CT in diagnosis of color Doppler ultrasound uncertain cervical lymph node metastasis after surgical resection of papillary thyroid carcinoma

作　　者：刘长江 董燕玉 胡翔 邓洪 王才顺 LIU Changjiang;DONG Yanyu;HU Xiang;DENG Hong;WANG Caishun(Department of Nuclear Medicine,Xingyi People's Hospital,Xingyi 562400,China;Forensic Science Identification,Xingyi People's Hospital,Xingyi 562400,China;Department of Ultrasound,Xingyi People's Hospital,Xingyi 562400,China)

机构地区：[1]兴义市人民医院核医学科,贵州兴义562400 [2]兴义市人民医院法医司法鉴定所,贵州兴义562400 [3]兴义市人民医院超声医学科,贵州兴义562400

出　　处：《中国医学影像技术》2020年第10期1456-1460,共5页Chinese Journal of Medical Imaging Technology

基　　金：黔西南州科技计划(2015-1-68)。

摘　　要：目的评估^99Tc^m-MIBI SPECT/CT诊断甲状腺乳头状癌(PTC)术后彩色多普勒超声(CDUS)疑似颈部淋巴结转移的价值。方法收集31例PTC术后CDUS疑似颈部淋巴结转移患者,均于术后1个月内接受颈部^99Tc^m-MIBI SPECT/CT扫描,之后15天内接受颈部^131I SPECT/CT扫描。观察^99Tc^m-MIBI SPECT/CT对于PTC术后颈部淋巴结转移的诊断效率。结果31例中,6例(6/31,19.35%)存在颈部淋巴结转移。^99Tc^m-MIBI SPECT/CT对PTC术后颈部淋巴结转移的敏感度、特异度、准确率、阳性预测值和阴性预测值分别为66.67%(4/6)、96.00%(24/25)、90.32%(28/31)、80.00%(4/5)和92.31%(24/26)。共确定14个颈部淋巴结转移灶,^99Tc^m-MIBI SPECT/CT诊断敏感度和阳性预测值分别为71.43%(10/14)和83.33%(10/12),首次^131I SPECT/CT为28.57%(4/14)和100%(4/4),^99Tc^m-MIBI SPECT/CT的敏感度高于^131I SPECT/CT(χ^2=5.14,P<0.05),其阳性预测值与首次^131I SPECT/CT差异无统计学意义(Fisher精确概率法,P>0.05)。结论^99Tc^m-MIBI SPECT/CT能确定大部分PTC颈部淋巴结转移灶,为判断^131I SPECT/CT和CDUS疑似淋巴结转移提供更多信息。Objective To explore the value of^99Tc^m-MIBI SPECT/CT in diagnosis of color Doppler ultrasound(CDUS)uncertain cervical lymph node metastasis after surgical resection of papillary thyroid carcinoma(PTC).Methods A total of 31 patients with CDUS uncertain cervical lymph node metastasis after surgical resection of PTC were collected.^99Tc^m-MIBI SPECT/CT of the neck was performed one month within operation,then^99Tc^m-MIBI SPECT/CT,^131I SPECT/CT of the neck were performed within 15 days.The diagnostic efficiency of^99Tc^m-MIBI SPECT/CT was observed.Results Among 31 PTC patients,cervical lymph node metastases were detected in 6(6/31,19.35%)patients.The sensitivity,specificity,accuracy,positive predictive value(PPV)and negative predictive value(NPV)of^99Tc^m-MIBI SPECT/CT was 66.67%(4/6),96.00%(24/25),90.32%(28/31),80.00%(4/5)and 92.31%(24/26),respectively.Totally 14 cervical metastatic lesions were found,the sensitivity and PPV of^99Tc^m-MIBI SPECT/CT in diagnosis of cervical metastatic lesions was 71.43%(10/14)and 83.33%(10/12),of^131I SPECT/CT was 28.57%(4/14)and 100%(4/4),respectively.^99Tc^m-MIBI SPECT/CT showed higher sensitivity than^131I SPECT/CT(χ^2=5.14,P<0.05)and similar PPV(Fisher exact test,P>0.05).Conclusion^99Tc^m-MIBI SPECT/CT could be used to correctly localize most cervical lymph node metastasis of PTC,providing further information for judging^131I SPECT/CT and CDUS uncertain cervical lymph node metastases in postoperative PTC patients.

关 键 词：甲状腺癌 乳头状 淋巴结转移 体层摄影术 发射型计算机 单光子 体层摄影术 X线计算机 99M锝甲氧基异丁基异腈 

分 类 号：R736.1[医药卫生—肿瘤] R817.4[医药卫生—临床医学]