99Tcm-MIBI显像对甲状腺结节良恶性鉴别诊断价值的研究

The diagnostic value of 99Tcm-MIBI imaging to benign and malignant thyroid lesions

目的 观察99Tcm-MIBI甲状腺结节双时相显像的特征,对照病理学检查结果,探讨99Tcm-MIBI早期及延迟显像对甲状腺良恶性结节的鉴别诊断价值.方法 89例经手术病理证实的甲状腺病变患者,其中,甲状腺癌患者38例,甲状腺良性病变患者51例,分别行甲状腺99Tcm-MIBI早期显像及延迟显像,对比分析早期及延迟显像中两组患者的T/NT值.结果 99Tcm-MIBI早期显像中,甲状腺癌组T/NT值（1.32±0.03）与甲状腺良性病变组T/NT值（1.26±0.22）相比,差异无统计学意义（t=0.63,P＞0.05）.99Tcm-MIBI延迟显像中,甲状腺癌组T/NT值（1.72±0.39）较甲状腺良性病变组T/NT值（1.20±0.36）增高,差异有统计学意义（t=3.45,P＜0.05）.结论 甲状腺99Tcm-MIBI早期显像对甲状腺癌的诊断有较高的灵敏度,但特异性较低;99Tcm-MIBI延迟显像能提高诊断的特异性,对甲状腺结节良、恶性的鉴别有较好效果.

Objective To observe the characteristic of 99Tcm-MIBI double-phase imaging, and compared with the pathologic result to discuss and evaluate the diagnostic and difference diagnostic value of earlyimaging and delayed-imaging to benign and malignant lesion in thyroid. Methods Eighty-nine pathological proven thyriod lesions patients were included in this study（38 cases of thyroid cancer and 51 cases of thyroid benign lesion）. 99Tcm-MIBI early-imaging and delayed-imaging of thyroid were performed, and comaratively analyzed the T/NT ratio of early-imaging and delayed-imaging of thyroid cancer and thyroid benign lesion.Results There was no significance in the T/NT ratio of 99Tcm-MIBI early-imaging between thyroid cancer group（ T/NT=1.32±0.03 ） and thyroid benign lesion group（ T/NT =1.26±0.22 ）（t=0.63,P〉0.05）. The T/NT ratio of delayed-imaging was high （T/NT=1.72±0.39 ）than that of benign lesion（T/NT= 1.20±0.36）, and there was statistically significance between them（t=3.45,P〈0.05）. Conclusions The sensitivity is high for diagnosing thyroid cancer through 99Tcm-MIBI early-imaging but specify is low, and specify is high for diagnosing thyroid cancer using 99Tcm-MIBI delayed-imaging, which is better for differencing malignancy from benignity in thyroid.