【摘要】 目的探讨核医学99mTcO-4与99mTc-MIBI联合显像鉴别甲状腺结节良恶性的临床价值。方法对入选的40例甲状腺结节病例术前行甲状腺99mTcO-4显像、99mTc-MIBI显像,根据结节的99mTc-MIBI与99mTcO-4摄取值,计算99mTc–MIBI/99mTcO-4摄取比值(即M/T值)。根据术后病理,分析M/T值及血清人促甲状腺激素(hTSH)水平与结节良恶性的关系。结果 40例中,5例甲状腺结节M/T比值≥2.0,病理结果为恶性结节(乳头状癌、滤泡状癌),与M/T值存在相关性(P<0.05);其余35例为良性结节(腺瘤、囊腺瘤),M/T值均<2.0。联合甲状腺99mTcO-4和99mTc-MIBI显像诊断甲状腺恶性结节的灵敏度为100%,特异度为94.3%,准确率为95%。良性结节与hTSH水平增高有关(P<0.05)。结论联合甲状腺99mTcO-4和99mTc-MIBI显像可对甲状腺结节的良恶性进行鉴别诊断,具有临床应用价值。更多还原

【Abstract】 Objective To investigate the clinical value of 99mTc-MIBI scintigraphy combined with 99mTcO-4 scintigraphy in differential diagnosis of benign and malignant thyroid nodules. Methods Forty cases with thyroid nodules were performed 99mTcO-4 scintigraphy and 99mTc-MIBI scintigraphy before surgery. The region of interest(ROI) uptake ratio of 99mTc-MIBI to 99mTcO4ˉ(M/T value) was calculated. The relationship between M/T value or blood human thyroid stimulating hormone(hTSH) level and benign and malignant nodules were analyzed according to the postoperative pathology. Results Among 40 cases, there were 5 cases with M/T value ≥2.0 and pathological results confirmed malignant(papillary carcinoma and follicular carcinoma). The pathological result was correlated with M/T value(P<0.05). The rest 35 cases with M/T values <2.0 were diagnosed benign nodules(adenoma and cystadenoma). The sensitivity was 100%,?specificity was?94.3%,?and accuracy was 95%. The benign nodule was associated with elevated hTSH level(P<0.05). Conclusion 99mTc-MIBI scintigraphy combined with 99mTcO-4 scintigraphy can differentially diagnose benign thyroid nodules from malignant ones, with application value in clinic.更多还原