^(99m)Tc-MIBI和^(99m)TcO_4^-比较显像诊断甲状腺结节的临床价值

Clinical Value of Combining 99mTcMIBI Imaging with 99mTcO4 Imaging in Differentiation of Thyroid Nodules

目的：探讨９９ｍＴｃＭＩＢＩ和９９ｍＴｃＯ４比较显象诊断甲状腺癌的价值。材料与方法：对１３９例患者甲状腺结节进行常规９９ｍＴｃＯ４显像及次日静脉注射９９ｍＴｃＭＩＢＩ７４０ＭＢｑ后３０ｍｉｎ比较显像，１３２例与病理结果对比。结果：１８／２０例甲状腺癌，３／４例颈淋巴结转移显像阳性。１１９例良性结节中３６例有放射性浓聚填充，其灵敏度、特异性及准确性分别为９０．０％，６９．７％和７２．７％。结合９９ｍＴｃＯ４显像判断分别为９０．０％，８３．２％和８４．２％。结论：９９ｍＴｃＭＩＢＩ显像对鉴别诊断甲状腺结节的良恶性有较高灵敏性及特异性，结合９９ｍＴｃＯ４显象判断有助于降低假阳性。

Purpose: To evaluate the value in differentiation of thyroid nodules using 99mTcMIBI imaging and 99mTcO4 imaging. Materials and methods: The images were acquired 30 min after injection of 740 MBq 99mTcMIBI, and analysed with naked eye and ROI along with 99mTcO4 Imaging. The results were compared in 132 of the 139 patients with Pathology. Results:BZ18 of 20 cases of thyroid carcinoma and 3 of 4 metastatic lymphonode in the neck had positive uptake of 99mTcMIBI, but only 36 of 119 cases with benign nodules showed positive imaging. Combining 99mTcMIBI imaging with 99mTcO4 imaging gained the diagnostic sensitivity, specifivity and accuracy of 90.0%,83.2% and 84.2% respectively, which were superior then 90.0%, 69.7% and 72.7% using 99mTcMIBI alone. Conclusions: The thyroid 99mTcMIBI imaging is sensitive and specific in detecting thyroid carcinoma. The false positive result could be reduced by combined evaluation with 99mTcO4imaging.