【摘要】 目的对比分析131I SPECT/CT平面显像与断层显像诊断分化型甲状腺癌(DTC)术后肺转移灶的价值。方法选取2007年8月—2012年8月在河北医科大学第四医院行DTC全切或次全切术后131I清除残余甲状腺组织治疗后,怀疑DTC肺转移患者32例,对患者分别行131I SPECT/CT平面显像和断层显像,并应用金标准确诊。评价两种诊断方法确诊DTC术后肺转移的灵敏度、特异度、准确性、阳性预测值和阴性预测值。结果根据金标准,32例患者中24例确诊为DTC肺转移,8例未发生肺转移。患者经131I SPECT/CT平面显像诊断肺转移20例,未发生肺转移12例,灵敏度为58.3%,特异度为25.0%,准确性为50.0%,阳性预测值为70.0%,阴性预测值为16.7%。患者经胸部131I SPECT/CT断层显像诊断肺转移26例,未发生肺转移6例,灵敏度为100.0%,特异度为75.0%,准确性为93.8%,阳性预测值为92.3%,阴性预测值为100.0%。131I SPECT/CT平面显像与断层显像对DTC术后肺转移诊断的灵敏度、特异度、阳性预测值和阴性预测值比较,差异均有统计学意义(χ2=12.63、4.00、3.92、11.25,P<0.05)。结论131I SPECT/CT断层显像对DTC术后肺转移灶的诊断价值优于平面显像,对怀疑DTC肺转移患者行131I SPECT/CT断层显像可提高肺转移检出率。更多还原

【Abstract】 Objective To investigate the value of131 I SPECT / CT planar imaging and tomography imaging for the diagnosis of pulmonary metastasis loci after surgery on differentiated thyroid carcinoma( DTC). Methods We enrolled 32 patients suspected of pulmonary metastasis of DTC after the131 I treatment following the total resection or partial resection of DTC received in the Fourth Hospital of Hebei Medical University from August 2007 to August 2012. The patients were administrated with131 I SPECT / CT planar imaging and tomography imaging and were diagnosed definitely using golden standard. The two diagnostic methods were evaluated in the sensitivity, specificity, accuracy, positive predictive value and negative predictive value in the diagnosis of lung metastasis after DTC surgery. Results According to golden standard,24 patients were diagnosed as the lung metastasis of DTC, and the rest 8 patients had no lung metastasis. Through131 I SPECT / CT planar imaging,20 patients were diagnosed as lung metastasis and 12 patients weren’t diagnosed as that; the sensitivity was 58. 3%,the specificity was 25. 0%,the accuracy was 50. 0%,the positive predictive value was 70. 0% and the negative predictive value was 16. 7%.Through131 I SPECT / CT tomography imaging,26 patients were diagnosed as lung metastasis and 6 patients weren’ t diagnosed as that; the sensitivity was 100. 0%, the specificity was 75. 0%, the accuracy was 93. 8%, the positive predictive value was92. 3% and the negative predictive value was 100. 0%. The131 I SPECT / CT planar imaging and tomography imaging were significantly different in the sensitivity, specificity, accuracy, positive predictive value and negative predictive value in the diagnosis of lung metastasis after DTC surgery( χ2= 12. 63,4. 00,3. 92,11. 25; P < 0. 05). Conclusion131 I SPECT / CT tomography imaging is superior to planar imaging in the diagnosis of lung metastasis after DTC surgery.131 I SPECT / CT tomography imaging on patients suspected with lung metastasis of DTC could improve the detection rate of lung metastasis.更多还原