放射性核素血管显象鉴别甲状腺“冷结节”良恶性的价值

The role of radionuclide angiography in differentiating malignant form begin cold thyroid nodules

分析了１１６例甲状腺“冷结节”ＲＮＡ。血供丰富的单发结节中，甲状腺癌占３７．０％，甲状腺腺瘤５９．３％，结节性甲肿３．７％；血供丰富的多发结节及有血供的单发结节癌的发生率分别为１６．７％和４．３％；有血供结节及无血供结节均为良性病变。恶性结节血供丰富的阳性率为９１．７％，高于甲状腺腺瘤（２６．２％）和结节性甲肿（１５．８％），差异有极显著性意义。甲状腺ＲＮＡ鉴别“冷结节”良恶性的灵敏度为９１．７％、特异性７８．８％、准确性８０．２％，与Ｂ超、触诊无显著性差异，但三者结合可提高诊断的特异性和准确性。

Analysis of 116 cases of 'cold' thyroid nodules performed radionuclide angiography (RNA) was undertaken to correlate their vascularity patterns with pathological nature in an attempt to differentiate between bening and malignant nodules. Of 27 solitary cold nodules with hypervascularity, 10(37.0%)were carcinoma, 16(59.3%)were adenoma,1(3.7%)was nodular goiter. Among hypervascular cold multinodules and hypovascular, solitary cold nodules, malignant nodules were 16.7%and 4.3%,respectively. The hypovascular multinodules and the avascular cold nodules were benign lesions. The hypervascularity rate of malignant nodules was 91.7%,which was far more than that of adenoma(26.2%)and nodular goiter(15.8%). There was a significant differnce(P<0.001) between malignant and benign nodules in statistics. This method resulted in 91.7%sensitivity, 78.8%specificity and 80.2%accuracy for the detection of malignant nodules. There were no statistically significant differences between RNA and ultrasonography or palpation of the thyroid in these indices. However, it can improve diagnostic specificity and accuracy that RNA is used in combination with ultrasonography and clinical palpation.