【摘要】 目的探讨99Tcm-HL91甲状腺肿瘤阳性显像的可行性,分析其诊断效能。方法对6例正常自愿者与70例经甲状腺扫描证实的甲状腺孤立冷结节患者进行99Tcm-HL91显像研究,用肉眼法与半定量分析法对诊断效能予以评价。结果(1)99Tcm-HL91在正常人甲状腺内几乎不摄取,4 h颈部占全身放射性约1.18%;(2)甲状腺99Tcm-HL91乏氧显像结果有4种类型,即热、温、冷结节与不显影,热结节主要见于甲状腺癌;(3)甲状腺癌T/N比值随时间有升高趋势,4 h显示了较好的显像品质;(4)肉眼与半定量法(阈值)判断对甲状腺癌诊断的灵敏度,特异性和准确性分别为77.78%、92.31%、88.57%;88.89%、92.31%、91.42%(T/N比值≥1.08)。2种判断方法之间比较无显著性差异(P>0.05)。结论(1)99Tcm-HL91甲状腺乏氧显像能够鉴别甲状腺孤立冷结节的性质,肉眼法与半定量分析法对甲状腺肿瘤具有相同的诊断效能。(2)推荐用4 h恶性组T/N比值的x-s为诊断阈值,对于进一步判断甲状腺肿瘤性质有重要临床价值。更多还原

【Abstract】 Objective To study the feasibility of ⁹⁹T_c^m-HL91 as a positive tumour tracer for thyroid and its diagnostic efficiency. Methods 6 normal volunteers and 70 cases of cold isolated thyroid nodule comfirmed by common ⁹⁹T_c^m scan underwent the biodistribution of ⁹⁹T_c^m-HL91.The diagnostic value were evaluated by using visualizaion and half quantitative analysis for all patients. Results（1）No uptake of ⁹⁹T_c^m-HL91 was nearly observed in normal thyroid gland.The radioactivity of neck was about 1.18% of that of the body at 4 hours after the administration of ⁹⁹Tc^m-HL91;（2）Four types of ⁹⁹T_c^m-HL91 thyroid hypoxic imaging were observed in all patient,those were hot,warm,cold nodule and no activation（no uptake）.Hot nodule was mainly found in thyroid carcinoma;（3）There was a tendency ascending of T/N ratios on thyroid carcinoma,⁹⁹T_c^m-HL91 as hypoxia marker exhibited good imaging characteristics at 4 hours;（4） The sensitivity,specificity and accuracy in visualization and half quantitative analysis（threshold analysis） were 77.78%,92.31%,88.57% and 88.89%,92.31%,91.42%（T/N ratio≥1.08）respectively,there were no significant difference in each ratio among the two different analyses（P>0.05）.Ⅰ Conclusion （1）⁹⁹T_c^m-HL91 hypoxic imaging can be able to identify cold isolated thyroid nodule,there is no difference between visualization and half quantitative analysis（threshold analysis）;（2）x-S of T/N ratio at 4 hours is recommend as diagnostic threshold of thyroid cancer,it is important to use the threshold for us to judge thyroid neoplasms further.更多还原