99mTcO4-与99mTc-MIBI显像联合彩色多普勒超声评分法对甲状腺结节良恶性的诊断价值

doi:10.3969/j.issn.1007-3969.2016.05.014

中国癌症杂志 ›› 2016, Vol. 26 ›› Issue (5): 434-440.doi: 10.3969/j.issn.1007-3969.2016.05.014

^99mTcO₄^-与^99mTc-MIBI显像联合彩色多普勒超声评分法对甲状腺结节良恶性的诊断价值

李　楠，毛夕保，薛宁娟，蒋凌云，包文骏，丁晨　，范　晶

苏州大学附属常州肿瘤医院，常州市第四人民医院核医学科，江苏常州 213001

出版日期:2016-05-30 发布日期:2016-06-23
通信作者: 李　楠　E-mail:kukud002@sina.com

Value of ^99mTcO₄^- and^99mTc-MIBI imaging with ultrasound scoring method in diagnosis of thyroid nodules

LI Nan, MAO Xibao, XUE Ningjuan, JIANG Lingyun, BAO Wenjun, DING Chenmin, FAN Jing

Department of Nuclear Medicine, Soochow University Affiliated Changzhou Tumor Hospital, Changzhou Fourth People’s Hospital, Changzhou 213001, Jiangsu Province, China

Published:2016-05-30 Online:2016-06-23
Contact: LI Nan E-mail: kukud002@sina.com

摘要/Abstract

摘要： 背景与目的：目前，彩色多普勒超声评分和核素显像是诊断甲状腺结节的两种重要影像学手段，但是二者检查原理不同，对临床诊断价值孰优，抑或二者联合诊断效果会更好，目前尚无定论。该研究旨在评价^99mTcO₄^-与^99mTc-甲氧基异丁基异腈(methoxyisobutylisonitrile，MIBI)显像联合彩色多普勒超声评分法对甲状腺结节良恶性的诊断价值。方法：对50例甲状腺结节患者共54个结节作回顾性研究，患者均已行常规彩色多普勒超声检查及^99mTcO₄^-与^99mTc-MIBI显像，以手术病理检查结果为“金标准”，比较^99mTcO₄^-与^99mTc-MIBI显像联合常规彩色多普勒超声评分法鉴别甲状腺结节良恶性的诊断灵敏度、特异度、准确度、阳性预测值及阴性预测值。结果：^99mTcO₄^-与^99mTc-MIBI显像诊断甲状腺结节的灵敏度、特异度、准确度、阳性预测值及阴性预测值分别为80.00%(16/20个)、70.59%(24/34个)、74.07%(40/54个)、61.54%(16/26个)、85.71%(24/28个)，常规彩色多普勒超声评分法为80.00%(16/20个)、88.24%(30/34个)、85.16%(46/54个)、80.00%(16/20个)、88.24%(30/34个)，两种影像学方法结合诊断为100.00%(20/20个)、64.71%(22/34个)、77.78%(42/54个)、62.50%(20/32个)、100.00%(22/22个)。两种影像学方法结合诊断灵敏度高于单独超声评分法或单独核医学检查(100.00%与80.0%、100.00%与80.00%，χ^２=4.444 4、4.444 4，P=0.035 0、0.035 0)，单独超声评分法诊断特异度高于两种影像学方法结合(88.24%与64.71%，χ^２=5.230 8，P=0.022 2)，但两种影像学方法结合诊断无一例假阴性。结论：^99mTcO₄^-与^99mTc-MIBI显像联合彩色多普勒超声评分法可以从结构和功能两方面更灵敏、更全面地评价甲状腺结节良恶性，以免漏诊。

关键词: 甲状腺结节, 放射性核素显像, 锝, 超声检查, 评分法

Abstract:

Background and purpose: At present, color Doppler ultrasound scoring and radionuclide imaging are two important imaging methods for diagnosing thyroid nodules, but their checking principle is different. Which method is better? Or combining them will be the best method for diagnosing thyroid nodules? This study aimed to compare the value of ^99mTcO₄^- combined with ^99mTc-methoxyisobutylisonitrile (MIBI) imaging, ultrasound scoring method and ultrasound scoring method+^99mTcO₄^-+^99mTc-MIBI imaging in diagnosis of thyroid nodules. Methods: The results of ultrasound scoring method and ^99mTcO₄^-combined with ^99mTc-MIBI imaging were compared in 50 patients with 54 thyroid nodules, and then compared with pathological findings. The sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of the methods were calculated. Results: A total of 54 thyroid nodules were found pathologically including 20 malignant and 34 benign nodules. The sensitivity, specificity, accuracy, PPV and NPV of ^99mTcO₄^-combined with ^99mTc-MIBI imaging were 80.00% (16/20), 70.59% (24/34), 74.07% (40/54), 61.54% (16/26), 85.71% (24/28), re-spectively. Those of ultrasound scoring method were 80.00% (16/20), 88.24% (30/34), 85.16% (46/54), 80.00% (16/20), 88.24% (30/34), respectively. And those of ultrasound scoring method+^99mTcO₄^-+^99mTc-MIBI imaging were 100.00% (20/20), 64.71% (22/34), 77.78% (42/54), 62.50% (20/32), 100.00% (22/22), respectively. The sensitivity of ultrasound scoring method+^99mTcO₄^-+^99mTc-MIBI imaging was higher than ultrasound scoring method or ^99mTcO₄^-+^99mTc-MIBI imaging along (100.00% vs 80.00%, 100.00% vs 80.00%, χ^２ value was 4.444 4 and 4.444 4, P value was 0.035 0 and 0.035 0, respectively). The specificity of ultrasound scoring method was higher than those of two methods combined together (88.24% vs 64.71%, χ^２ value was 5.230 8, P value was 0.022 2). However, no factorial negative thyroid nodule was found by ultrasound scoring method+^99mTcO₄^-+^99mTc-MIBI imaging. Conclusion: Ultrasound scoring method+^99mTcO₄^-+^99mTc-MIBI imaging can offer comprehensive diagnosis of thyroid nodules from their structure and function to avoid missed diagnosis.

Key words: Thyroid nodule, Radionuclide imaging, Technetium, Ultrasonography, Scoring

李　楠,毛夕保,薛宁娟,等. ^99mTcO₄^-与^99mTc-MIBI显像联合彩色多普勒超声评分法对甲状腺结节良恶性的诊断价值[J]. 中国癌症杂志, 2016, 26(5): 434-440.

LI Nan, MAO Xibao, XUE Ningjuan, et al. Value of ^99mTcO₄^- and^99mTc-MIBI imaging with ultrasound scoring method in diagnosis of thyroid nodules[J]. China Oncology, 2016, 26(5): 434-440.

[1]	陈俊慧，张　曼，刘水澎，马　琳，刘　洋，李晓松，孟　健，李　劼，张树华. 基于超声征象多因素logistic回归β值积分法的甲状腺癌风险预测研究[J]. 中国癌症杂志, 2019, 29(4): 289-293.
[2]	乌拉木·玉努斯，周娜，柳紫阳，郭瑞，孟庆荣，李红斌. 超声筛查乳腺癌模式在基层医院应用的研究[J]. 中国癌症杂志, 2019, 29(2): 148-152.
[3]	刘如玉,张　波. 美国放射学会甲状腺结节影像报告系统和影像偶发甲状腺结节管理系列白皮书解读[J]. 中国癌症杂志, 2018, 28(2): 88-97.
[4]	李小毅. 2015年美国甲状腺学会《成人甲状腺结节与分化型甲状腺癌诊治指南》解读：外科部分[J]. 中国癌症杂志, 2016, 26(1): 13-18.
[5]	张　彬. 重视甲状腺结节的过度治疗问题[J]. 中国癌症杂志, 2016, 26(1): 43-46.
[6]	郭振清,赵　腾,孙谟健,等. 青岛地区1 306例甲状腺癌的临床病理特征分析[J]. 中国癌症杂志, 2016, 26(1): 53-59.
[7]	李文波,张　波,朱庆莉,等. 三维能量多普勒超声血管成像在甲状腺结节良恶性诊断中的应用价值[J]. 中国癌症杂志, 2016, 26(1): 60-66.
[8]	龙江,罗国培,金凯舟,郭萌,刘祖强,肖志文,刘亮,刘辰,徐近,常才,倪泉兴,虞先. 胰腺实性假乳头状瘤的超声表现[J]. 中国癌症杂志, 2014, 24(9): 676-678.
[9]	李毅,吕艳丽,赵越等. 不同组织模式下乳腺癌筛查结果分析[J]. 中国癌症杂志, 2014, 24(12): 944-950.
[10]	郑宇佳,王明伟,张建平,徐俊彦,杨忠毅,程竞仪,张勇平,章英剑. ¹⁸F-SFB-Annexin B1探测化疗后肿瘤细胞凋亡的实验研究[J]. 中国癌症杂志, 2013, 23(10): 798-803.

^99mTcO₄^-与^99mTc-MIBI显像联合彩色多普勒超声评分法对甲状腺结节良恶性的诊断价值

Value of ^99mTcO₄^- and^99mTc-MIBI imaging with ultrasound scoring method in diagnosis of thyroid nodules

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 10

编辑推荐

Metrics

本文评价