^(18)F-FDG-PET-CT在分化型甲状腺癌诊断、分期判定及预后判定中的价值探讨  

The value of(18)F-FDG-PET-CT in the Diagnosis,Stage Judging and Prognosis Judging of Differentiated Thyroid Cancer

作　　者：王欢[1] 何涛 李叔俊 WANG Huan;HE Tao;LI Shu-jun(Department of Nuclear Medicine,Medical Imaging Center,Panzhihua Central Hospital,Panzhihua 617067,Sichuan Province,China)

机构地区：[1]攀枝花市中心医院医学影像中心核医学科,四川攀枝花617067

出　　处：《中国CT和MRI杂志》2021年第6期52-54,共3页Chinese Journal of CT and MRI

摘　　要：目的探讨^(18)F-氟脱氧葡萄糖(^(18)F-FDG)-PET-CT在分化型甲状腺癌(DTC)诊断、分期判定及预后判定中的价值。方法病例来源于2016年2月至2017年2月收治的70例甲状腺良恶性疾病患者,均行全身^(18)F-FDG-PET-CT扫描检查,以术后组织病理学结果为"金标准",评估^(18)F-FDG-PET-CT对DTC诊断、分期判定中的效能,并对确诊患者预后进行随访,分析^(18)F-FDG-PET-CT在DTC预后判定中的价值。结果 ^(18)F-FDG-PET-CT诊断DTC的灵敏度为73.08%,特异度为88.89%,准确度为77.14%,阳性预测值为95.00%,阴性预测值为53.33%,Kappa值为0.509,^(18)F-FDG-PET-CT诊断DTC分期的准确性为96.59%;术后随访期间^(131)I-WBS检查则发现,52例患者中有12例患者远处转移灶均呈阳性,但行^(18)F-FDG-PET-CT检查则呈阴性,有3例患者经医师观察、实验室检查均无明显变化,但有2例^(131)I-WBS检查为阴性而^(18)F-FDG-PET-CT检查为阳性,1例经^(131)I-WBS检查、^(18)F-FDG-PET-CT检查均为阴性。结论 ^(18)F-FDG-PET-CT在DTC鉴别诊断中的灵敏度、特异度和准确度不高,但对DTC分期判定和预后判定中有明确价值,在预后判定中结合^(131)I-WBS检查可提高对患者预后的评估效果。Objective To investigate the value of 18F-fluorodeoxyglucose(18 F-FDG)-PET-CT in the diagnosis,stage judging and prognosis judging of differentiated thyroid carcinoma(DTC).Methods Seventy patients with benign and malignant thyroid diseases admitted from February 2016 to February 2017 were enrolled in the study.All of them we re examined by systemic 18F-FDG-PET-CT.Taking the postoperative histopathological results as gold standard,the efficacy of 18 F-FDG-PET-CT in the diagnosis and staging of DTC was evaluated,the prognosis of the confirmed patients were followed u p,the value of 18F-FDGPET-CT in the prognosis of DTC was analyzed.Results The sensitivity,specificity,accuracy,positive predictive value,negative predictive value,and Kappa value of 18F-FDG-PET-CT for diagnosis of DTC were 73.08%,88.89%,77.14%,95.00%,53.33%,and 0.509,respectively.The accuracy of 18F-FDGPET-CT for PET-CT diagnosis of DTC staging was 96.59%.^(131)Ⅰ-WBS examination during postoperative follow-up found that 12 of 52 patients were positive in distant metastases,but it was negative with18F-FDG-PET-CT.There were 3 patients no significa nt changes after medical observation and la borato ry examination,there were 2 patients with negative result by ^(131)Ⅰ-WBS and positive result by 18F-FDGPET-CT,1 patient with negative result by ^(131)Ⅰ-WBS and 18F-FDG-PET-CT.All 18 F-FDG-PET-CT examinations were negative.Conclusion The sensitivity,specificity,and accu ra cy of 18 F-FDG-PET-CT in DTC differential diagnosis are not high,but have clear value in DTC staging judging and prognosis judging.Combing prognosis judging with 1311-WBS examination can improve evaluating effects of the prognosis of patients.

关 键 词：分化型甲状腺癌 ^(18)F-FDG-PET-CT 诊断 分期判定 预后判定 

分 类 号：R322.51[医药卫生—人体解剖和组织胚胎学]