目的探讨甲状腺摄99mTcO4-功能显像、彩色超声多普勒检查及其两者联合检查,对甲状腺结节性质的诊断价值。方法对我院2014年8月至2018年9月期间同时行超声检查及核素显像并有病理结果对照的112例患者共147个结节进行回顾性分析,对比超声...目的探讨甲状腺摄99mTcO4-功能显像、彩色超声多普勒检查及其两者联合检查,对甲状腺结节性质的诊断价值。方法对我院2014年8月至2018年9月期间同时行超声检查及核素显像并有病理结果对照的112例患者共147个结节进行回顾性分析,对比超声和核素检查及其两者联合检查对甲状腺结节的诊断效能并探讨单发良恶性结节半定量参数的差异。结果(1)其中147个结节中经病理诊断证实为甲状腺癌16个,良性甲状腺结节131个。(2)甲状腺摄锝99mTcO4-功能显像、彩超检查及两者联合的对甲状腺结节诊断的敏感性分别为75.0%、43.8%和93.8%(χ2=3.329、2.133、9.309,P=0.072、0.144、0.001),特异性分别为65.6%、84.7%和58.0%(χ2=12.788、1.617、22.884,P<0.001、0.203、<0.001),准确率分别为66.7%、80.3%和61.9%(χ2=6.980、0.726、12.065,P=0.008、0.394、<0.001),假阳性率分别为34.4%、15.3%和42.0%(χ2=12.788、1.617、22.884,P<0.001、0.203、<0.001),假阴性率分别为25.0%、56.2%和6.2%(χ2=3.329、2.133、9.309,P=0.072、0.144、0.001)。(3)甲状腺良性结节组与甲状腺癌组的甲状腺直观指数(visualindex of thyroid uptake,VITU)分别为4.18±3.94和2.35±1.60(t=1.326,P=0.190),良性甲状腺结节与甲状腺癌的摄99mTcO4-功能(病变部位的放射性浓度/周围正常甲状腺组织放射性浓度L/N)分别为0.53±0.39和0.49±0.18(t=0.212,P=0.833)。结论甲状腺99mTcO4-功能显像对甲状腺恶性结节的鉴别诊断有一定的应用价值,并能提供甲状腺的功能信息,超声联合核素显像能减少恶性结节的漏诊率。展开更多
PURPOSE: To study the discriminatory ability of dacryoscin-tigraphy in differentiating between patients with epiphora and volunteers using a simple method. Methods: Twenty eyes in ten volunteers and 66 eyes in 55 pati...PURPOSE: To study the discriminatory ability of dacryoscin-tigraphy in differentiating between patients with epiphora and volunteers using a simple method. Methods: Twenty eyes in ten volunteers and 66 eyes in 55 patients with severe epiphora were studied. Dacryoscintigraphy (15 frames of 1min)was performed after administration of 4 MBq 99m Tc-pertechnetate (10 μl) in both eyes. By mapping a single region of interest (ROI)-over the conjunctival sac we determined T1 (%dose in first minute) and linear clearance rate (LCR, defined as 100%(T1-T15)/T1 from the tracer disappearance curve. Reproducibility was determined in volunteers. Conjunctival resorption was determined from completely obstructed systems. Sensitivity and specificity were calculated and receiver operating characteristics (ROC) analysis was conducted. Results: In volunteers mean T1 was 52.8±11.9%(95%CI 47.1-58.4%), and LCR was 74.2±11.1%(95%CI 69.0-79.4%). Reproducibility was good (mean difference 4.1±13.3%for T1 and 0.7±17%for LCR). Epiphora patients had clearly higher T1 (82.1±15.2%, P< 0.0001) and lower LCR (38.9±22.5%, P< 0.0001) values. Tracer resorption was 24%. Based on ROC analysis 70%for T1 and 50%for LCR were considered optimal cut-off levels to separate patients from volunteers. Sensitivity/specificity were 77/95%for T1 and 71/100%for LCR. T1 and LCR values did not correlate with symptomscores or Anel test results. Conclusion: Dacryoscintigraphy, using LCR and T1 as parameters, is a reliable and objectivemethod to detect tear-flow abnormalities.展开更多
文摘目的探讨甲状腺摄99mTcO4-功能显像、彩色超声多普勒检查及其两者联合检查,对甲状腺结节性质的诊断价值。方法对我院2014年8月至2018年9月期间同时行超声检查及核素显像并有病理结果对照的112例患者共147个结节进行回顾性分析,对比超声和核素检查及其两者联合检查对甲状腺结节的诊断效能并探讨单发良恶性结节半定量参数的差异。结果(1)其中147个结节中经病理诊断证实为甲状腺癌16个,良性甲状腺结节131个。(2)甲状腺摄锝99mTcO4-功能显像、彩超检查及两者联合的对甲状腺结节诊断的敏感性分别为75.0%、43.8%和93.8%(χ2=3.329、2.133、9.309,P=0.072、0.144、0.001),特异性分别为65.6%、84.7%和58.0%(χ2=12.788、1.617、22.884,P<0.001、0.203、<0.001),准确率分别为66.7%、80.3%和61.9%(χ2=6.980、0.726、12.065,P=0.008、0.394、<0.001),假阳性率分别为34.4%、15.3%和42.0%(χ2=12.788、1.617、22.884,P<0.001、0.203、<0.001),假阴性率分别为25.0%、56.2%和6.2%(χ2=3.329、2.133、9.309,P=0.072、0.144、0.001)。(3)甲状腺良性结节组与甲状腺癌组的甲状腺直观指数(visualindex of thyroid uptake,VITU)分别为4.18±3.94和2.35±1.60(t=1.326,P=0.190),良性甲状腺结节与甲状腺癌的摄99mTcO4-功能(病变部位的放射性浓度/周围正常甲状腺组织放射性浓度L/N)分别为0.53±0.39和0.49±0.18(t=0.212,P=0.833)。结论甲状腺99mTcO4-功能显像对甲状腺恶性结节的鉴别诊断有一定的应用价值,并能提供甲状腺的功能信息,超声联合核素显像能减少恶性结节的漏诊率。
文摘PURPOSE: To study the discriminatory ability of dacryoscin-tigraphy in differentiating between patients with epiphora and volunteers using a simple method. Methods: Twenty eyes in ten volunteers and 66 eyes in 55 patients with severe epiphora were studied. Dacryoscintigraphy (15 frames of 1min)was performed after administration of 4 MBq 99m Tc-pertechnetate (10 μl) in both eyes. By mapping a single region of interest (ROI)-over the conjunctival sac we determined T1 (%dose in first minute) and linear clearance rate (LCR, defined as 100%(T1-T15)/T1 from the tracer disappearance curve. Reproducibility was determined in volunteers. Conjunctival resorption was determined from completely obstructed systems. Sensitivity and specificity were calculated and receiver operating characteristics (ROC) analysis was conducted. Results: In volunteers mean T1 was 52.8±11.9%(95%CI 47.1-58.4%), and LCR was 74.2±11.1%(95%CI 69.0-79.4%). Reproducibility was good (mean difference 4.1±13.3%for T1 and 0.7±17%for LCR). Epiphora patients had clearly higher T1 (82.1±15.2%, P< 0.0001) and lower LCR (38.9±22.5%, P< 0.0001) values. Tracer resorption was 24%. Based on ROC analysis 70%for T1 and 50%for LCR were considered optimal cut-off levels to separate patients from volunteers. Sensitivity/specificity were 77/95%for T1 and 71/100%for LCR. T1 and LCR values did not correlate with symptomscores or Anel test results. Conclusion: Dacryoscintigraphy, using LCR and T1 as parameters, is a reliable and objectivemethod to detect tear-flow abnormalities.
