^(99m)Tc甲状腺/颈本底校正比在甲状腺疾病中应用价值的探讨

Exploration of the value of ^(99m)Tc thyroid/neck background rectified ratio in thyroid disease

对 4 9例健康者及 2 5 0例甲状腺疾病患者进行甲状腺显像 ,计算反映甲状腺摄99mTc功能的指标 :校正比、摄取比及摄99mTc率。进行校正比、摄99mTc率之间的一致性与摄取比、摄99mTc率之间的一致性比较及各疾病组与正常组之间的指标比较。结果表明 ,方法校正比与摄99mTc率的总实际一致率为 95 .6 % ,显著高于摄取比与摄99mTc率总实际一致率 77.9% (χ2 =4 0 .9,P <0 .0 0 1) ;甲亢组、甲亢术后复发组校正比显著高于正常组 (P <0 .0 5— 0 .0 0 5 ) ,亚甲炎组校正比显著低于正常组 (p <0 .0 0 1) ;单纯性甲状腺肿大组校正比可正常或增高 ,甲减组校正比可正常、增高或减低。结果提示 ,校正比反映甲状腺摄99mTc程度明显优于摄取比 ,校正比用于诊断甲亢或甲减还很困难 。

normal subjects and 250 patients with thyroid disease were performed thyroid imaging. The parameters reflecting the function of thyroid were calculated,including rectified ratio(RR),uptake ratio(UR) and 99m Tc percentage uptake(PU).The identity between RR and PU was compared with the identify between UR and PU. The parameters in disease groups were also compared with that of normal group. The results showed that the real identify percentage (95.6%) between RR and PU was significantly higher than that of UR and PU (77.9%) ( χ 2=40.9, P <0.001). RR were significantly higher in groups of hyperthyroidism and recurrence after thyroidectomy than normal group ( P <0.05-0.005),and significantly lower in subacute thyroiditis group ( P <0.001).RR may be normal or increased in simple goiter and may be normal, increased or decreased in hypothyroidism. Thereby, RR is obviously better than UR in determining the level of thyroid 99m Tc uptake. It is difficult in discriminating between hyperthyroidism and hypothyroidism by RR, but it still has important significance in correlation with clinical and other examination data for comprehansive judgement.