PET/CT高摄取甲状腺结节的高频超声诊断价值初探

Value of high frequency ultrasonography in diagnosis of PET/CT high enhanced thyroid lesions

目的评价对于PET/CT检查时偶然发现的甲状腺高摄取结节再行高频超声检查的临床价值。方法2007年6月至2007年8月,4例在我院行PET/CT检查时偶然发现的甲状腺结节,其在PET/CT上皆表现为18F-FDG高摄取病灶,随后由两名有经验的超声医师对发现的病灶进行高频超声检查,作出良恶性诊断。以手术病理结果为金标准,评价高频超声对于PET/CT高摄取甲状腺结节诊断的额外价值。结果4例病例皆为行PET/CT检查时偶尔发现的甲状腺高摄取病灶,患者无自觉症状,亦无既往病史;病灶的SUV值都大于5.0,部分行延迟显像示SUV持续升高,PET/CT都提示恶性病灶;经两名有经验的超声医师检查后提示良性病变;术后的病理结果也支持了超声的诊断,为甲状腺良性肿瘤。结论PET/CT是一种很灵敏的恶性肿瘤检查方法,对于常规检查时偶然发现的甲状腺高摄取病灶,还应进一步行高频超声检查,两者互补,能够减少假阳性诊断的发生。

Objective To discuss the value of high frequency ultrasonography in diagnosis of occasionally detected PET/CT high enhanced thyroid Lesions Methods From June to August 2007, in the PET/CT center of our hospital, 4 patients were occasionally detected high enhanced thyroid lesions in their routine PET/CT exams. Then, all these thyroid lesions were received high frequency ultrasound exam by experienced physicians. Post-operation pathological results were used as golden standard to discuss the extra value of high frequency ultrasound used in PET/CT high enhanced thyroid lesions. Results All these thyroid lesions were detected occasionally in routine PET/CT exams. These patients showed no signs and symptoms, and had no thyroid diseases history. All lesions were showed as 18^SF-FDG high enhanced patterns in PET/CT images, with SUV value more than 5.0, diagnosed as malignant disease by PET/CT. High frequency ultrasound exam were performed by two experienced physicians, they all diagnosed these lesions as benign disease, and post-operation pathological results supported the diagnosis of ultrasound. Conclusion PET/CT is a sensitive method to detect malignant disease. As to the diagnosis of occasional detected PET/CT high enhanced thyroid Lesions, high frequency ultrasound exam are necessary to avoid the false positive diagnosis.