99m TcO4-核素显像联合超声检查对甲状腺结节的鉴别诊断价值

目的 探讨99mTcO4-核素显像联合超声检查对甲状腺结节的诊断价值.方法 以术后病理结果为金标准,对苏州大学附属第二医院2006年4月至2010年8月114例患者的125个甲状腺结节的99mTcO4-核素显像及超声检查结果进行对比研究.结果(1)125个结节中,甲状腺腺瘤所占比例为51.2％,甲状腺癌仪占24.0％,其他甲状腺病变占24.8％;核素显像中“冷”结节占73.6％,其中甲状腺癌占25.0％;超声检查中以实性结节和囊实性结节为主且实性结节的恶性率最高.(2)实性“凉”、“冷”结节与囊实性“凉”、“冷”结节的恶性率差异有统计学意义(P＜0.05).(3)在直径＞2.0 cm的实性“凉”、“冷”结节中,甲状腺癌占62.5％.结论 99mTcO4-核素显像联合超声检查有助于评价甲状腺结节的摄取能力,对鉴别诊断甲状腺结节良恶性起着重要作用.

Values of (99m)TcO(-)(4)thyroid imaging plus ultrasonography in the differential diagnoses of thyroid nodules

Objective To evaluate the diagnostic values of 99mTcO4-thyroid imaging plus ultrasonography in the differentiation of benign and malignant thyroid nodules.Methods 99mTcO4-thyroid imaging and ultrasonography were performed for 114 patients with 125 thyroid nodules.And the examination results were compared with the post-operative pathological findings.Results(1)Among 125 thyroid nodules,there were thyroid adenoma(n =64,51.2％),thyroid cancer(n =30,24.0％)and other thyroid diseases(n =31,24.8％).On thyroid images,73.6％ of them were of cold nodules.And among these cold nodules,25.0％ were of thyroid cancer.Among the ultrasonic results,125 nodules were predominantly of solid nodules and mixed solid and cystic nodules while the malignant rate of solid nodules was the highest.(2)The malignant rate of solid cool or cold nodules was greater than those of mixed solid and cystic cool or cold nodules(P ＜0.005).(3)In solid cool or cold nodules with a diameter of ≥2.0 cm,thyroid cancer accounted for 62.5％.Conclusion The combination of 99mTcO4-thyroid imaging and ultrasonography may help to evaluate the 99mTcO4-uptaking functions of thyroid nodules so that it plays an important role in the differentiation of benign and malignant thyroid nodules.