^(99m)Tc-MIBI显像对甲状腺结节良恶性鉴别诊断的临床意义

The Clinical Significance of ^(99m)Tc-MIBI Imaging in the Differential Diagnosis of Thyroid Carcinoma and Benign Lesions

目的 :探讨99mTc -MIBI显像对甲状腺结节良性与恶性鉴别诊断的临床应用价值。方法 :共 33例甲状腺结节患者 ,分为甲状腺癌和甲状腺良性病变两组 (分别为 6例和 2 7例 )。常规甲状腺99mTcO- 4显像 4 8h以后进行99mTc -MIBI显像 ,静态采集两次 ,即静注 2 0～ 2 5mCi(74 0～92 5MBq) 99mTc -MIBI后 2 0min内的甲状腺早期显像和 1 5h后的晚期显像 ,计算出早期和晚期摄取比值 ,并根据公式求出滞留指数 (RI) :RI =(晚期摄取比值—早期摄取比值 ) /早期摄取比值 ,显像结果与病理检查结果相比较分析。结果 :甲状腺癌组与甲状腺良性病变组相比 ,早、晚期摄取比值和RI皆高于甲状腺良性病变组 ,差异显著 (P <0 0 5) ;以甲状腺癌组RI的 x -s(-0 0 4 9)为判断阈值 ,99mTc -MIBI显像对甲状腺癌诊断的灵敏度、特异性和准确性分别为83 3%、81 5%和 81 8%。结论99mTc -MIBI显像对甲状腺结节良恶性鉴别诊断有较大的临床应用价值 ,判断指标以滞留指数为最好。

Objective: To evaluate the clinical significance of 99m Tc-MIBI imaging in the differential diagnosis of thyroid carcinoma and benign lesions. Methods:33 patients with 33 thyroid nodules which were divided into malignant groups (MG) and benign groups (BG) (6 and 27 cases respectively) were investigated.48hrs after 99m TcO - 4 thyroid imaging,the early and late anterior static images were acquired at 20min and 1.5hr after injection of 740～925MBq 99m Tc-MIBI. Then the early and delay uptake rate (UR),and the retention index (RI),were calculated. Finally the images were analysed compared with the pathological results. Results:Both early and delay UR and RI were higher in MG than that in BG ( P <0.05). If RI of the MG(-s,-0.049)was taken as the diagnostic threshold, the sensitivity,specificity and accuracy were 83.3%,81.5%,and 81.8%,respectively.Conclusions:The thyroid 99m Tc-MIBI imaging has clinical significance in the differential diagnosis of thyroid carcinoma and benign lesions. RI may be the best index for differential diagnosis.