^(99m)Tc锝-甲氧基异丁基异睛亲肿瘤显像对甲状腺单发结节的鉴别诊断价值

Value of ^(99m)Tc-MIBI imaging in differential diagnosis of solitary thyroid nodule

目的探讨99mTc锝-甲氧基异丁基异睛(99mTc-MIBI)亲肿瘤显像对甲状腺单发结节的诊断价值。方法 41例甲状腺单发结节并甲状腺99mTc(高得酸盐(99mTcO(4)显像示为"冷"或"凉"结节的患者,行99mTc-MIBI亲肿瘤显像。测定99mTc-MIBI亲肿瘤显像早期相(20min)及延迟相(2h)结节部位的摄取比值(T/N),根据早期相结节部位出现异常放射性浓聚,且延迟相出现放射性滞留判断为显像阳性。良恶性病变T/N比值的比较采用两样本t检验。患者均行外科手术治疗,并作病理检查。结果 99mTc-MIBI亲肿瘤显像阳性16例(包括良性病变2例),阴性25例(包括恶性病变1例)。其对甲状腺癌诊断的灵敏度、特异性和准确性分别为87.50%、96.00%、92.68%;甲状腺恶性病变早期相T/N比值显著高于良性病变早期相T/N比值(t=6.701,P<0.001),甲状腺恶性病变延迟相T/N比值(1.3820±0.2359)亦显著高于良性病变延迟相T/N比值(t=7.648,P<0.001)。结论 99mTc-MIBI亲肿瘤显像对甲状腺单发结节的鉴别诊断具有较高的临床价值。

Objective To evaluate the diagnostic effect of 99mTc-MIBI imaging on the single thyroid nodule.Methods 41 patients with solitary thyroid nodule presenting as ＂cold＂ or ＂cool＂ nodule in 99mTcO4-imaging were examined with thyroid 99mTc-MIBI imaging.The uptake ratios（T/N） of 99mTc-MIBI were mensurated at 20 min and 2 h after injection separately.The criterion of positive imaging was described as abnormal radioactive condenseness at early phase and abnormal radioactive retention at delay phase.The uptake ratios（T/N） of benign and malignant lesions were compared by two-sample t-test.All the patients underwent surgical treatment and pathological demonstration.Results The thyroid 99m Tc-MIBI imagings were positive in 16 cases（including 2 benign lesions） and negative in 25 cases（including one benign lesion）.The sensitivity,specificity and accuracy of the diagnosis for thyroid carcinoma by 99mTc-MIBI imaging were 87.50%、96.00% and 92.68% respectively.The difference of T/N ratios between the malignant group and the benign group at early phase was statistically significant（t=6.701,P0.001）.At delay phase,the difference of T/N ratios between the two groups was also statistically significant（t=7.648,P0.001）.Conclusion 99mTc-MIBI imaging may be valuable for the differential diagnosis of solitary thyroid nodule.