分化型甲状腺癌术后肺转移的SPECT/CT平面与断层显像诊断研究

Study of SPECT/CT planar and tomography imaging in the diagnosis of postoperative lung metastases of differentiated thyroid carcinoma

目的比较分化型甲状腺癌术后肺转移的单光子/正电子发射断层成像术(SPECT/CT)平面与断层显像诊断价值。方法回顾性分析中山大学附属第三医院2012年1月至2016年10月收治的64例疑似分化型甲状腺癌术后肺转移患者的临床资料,所有患者均同时接受SPECT/CT平面与断层显像,对显像诊断结果进行统计分析。结果 64例患者中确诊为分化型甲状腺癌术后肺转移48例,未发生肺转移16例。SPECT/CT平面显像诊断40例为肺转移,其中12例为假阳性;24例未发生肺转移,其中20例为假阴性。SPECT/CT断层显像诊断52例为肺转移,其中48例为真阳性;12例未发生肺转移,其中4例为假阳性。分化型甲状腺癌术后肺转移的SPECT/CT断层显像的敏感度、特异度、准确性、阳性预测值、阴性预测值均显著高于SPECT/CT平面显像(χ2=12.63、4.00、11.14、3.92、11.25,P=0.032、0.033、0.024、0.042、0.013)。结论分化型甲状腺癌术后肺转移的SPECT/CT断层显像诊断价值较SPECT/CT平面显像高,值得在临床推广。

Objective To compare the diagnostic values of SPECT/CT planar and tomography imaging in postoperative lung metastases of differentiated thyroid carcinoma. Methods Sixty-four cases with suspected postoperative lung metastasis of differentiated thyroid carcinoma from January 2012 to October 2016 were retrospectively analyzed in the Third Affiliated Hospital of Sun Yat-sen University. All patients were given SPECT/CT planar and tomography imaging, and the diagnostic results of SPECT/CT planar and tomography imaging in postoperative lung metastases of differentiated thyroid carcinoma were statistically analyzed. Results Among the 64 cases, there were 48 cases of postoperative lung metastases of differentiated thyroid carcinoma, and 16 non pulmonary metastasis. SPECT/CT planar imaging showed lung metastasis in 40 cases, of which 12 were false positive, and non pulmonary metastasis in 24 cases, of which 20 were false negative. SPECT/CT tomographic imaging diagnosed lung metastasis in 52 cases, of which 48 cases were true positive, and non puhnonary metastasis in 12 cases, of which 4 were false positive. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of SPECT/CT tomographic imaging of postoperative lung metastases of differentiated thyroid carcinoma were significantly higher than that of SPECT/CT planar imaging （X2=12.63, 4.00, 11.14, 3.92, 11.25, P=0.032, 0.033, 0.024, 0.042, 0.013 ）. Conclusion The diagnostic value of SPECT/CT tomography imaging in postoperative lung metastases of differentiated thyroid carcinoma is higher than SPECT/CT planar imaging, and is worthy of promotion in the clinic.