^99Tc^m-MIBI动态血流灌注显像和双时相核素显像对甲状腺冷结节良恶性的诊断价值研究

Study on the diagnostic value of ^99Tc^m-MIBI dynamic blood flow perfusion imaging and double-phase radionuclide imaging in benign and malignant cold thyroid nodules

目的探讨^99Tc^m-MIBI动态血流灌注显像和双时相显像对甲状腺冷结节良恶性的诊断价值。方法回顾性分析甲状腺冷结节行手术治疗的患者28例，所有患者使用配备低能高分辨准直器的SPECT仪行^99Tc^m-MIBI动态血流灌注、30min早期相及120min延迟相静态平面显像，并用T／NT值等综合分析显像结果。结果9例甲状腺癌患者在动态血流灌注、30min早期相和120min延迟相显像中阳性数分别为5例、6例、7例；19例良性病变患者在动态血流灌注、30min早期相和120min延迟相显像中阴性数分别为14例、11例、16例。^99Tc^m-MIBI动态血流灌注显像诊断甲状腺癌的灵敏度为55．56％，特异度为73．68％，准确率为67．85％；30min早期相显像诊断甲状腺癌的灵敏度为66．67％，特异度为57．89％，准确率为67．85％；120min延迟相显像诊断甲状腺癌的灵敏度为77．78％，特异度为84．21％，准确率为82．14％。结论^99Tc^m-MIBI的双时相显像对甲状腺冷结节的诊断和鉴别诊断具有一定价值，通过对动态血流灌注和^99Tc^m-MIBI的双时相显像中T／NT值等综合分析，可以降低假阳性和假阴性的发生。

Objective To study the value of ^99Tc^m-MIBI dynamic blood flow peffusion imaging and double-phase radionuclide imaging in benign and malignant cold thyroid nodules. Methods Retrospective analysis of surgical treatment of cold thyroid nodules of 28 patients. Use dual-head SPECT with low energy and high resolution collimator to get dynamic ^99Tc^m-MIBI blood flow perfusion imaging, 30 min early-phase and 120 min delayed-phase static planar imaging. The images are comprehensive analysed by T/NT and other methods. Results Nine cases of thyroid cancer in the dynamic blood flow perfusion, 30 min early-phase and 120 min delayed-phase static planar imaging, contain positive imaging 5, 6 and 7 cases respectively. 19 cases of benign lesions contain negative imaging 14, 11 andl6 cases respectively. Sensitivity of ^99Tc^m-MIBI dynamic perfusion imaging in the diagnosis of thyroid cancer is 55.56%, specificity is 73.68%, accuracy is 67.85%. Sensitivity of 30 rain early-phase static planar in the diagnosis of thyroid cancer is 66.67%, specificity is 57.89%, accuracy is 67.85%. Sensitivity of 120 rain delayed-phase static planar imaging in the diagnosis of thyroid cancer is 77.78%, specificity is 84.21%, accuracy is 82.14%. Conclusions ^99Tc^m-MIBI dual-phase imaging in the diagnosis and differential diagnosis of cold thyroid nodules has some value, comprehensive analysis of the blood perfusion and the T/NT of ^99Tc^m-MIBI dual-phase imaging can reduce the occurrence of false positive and false negative cases.