联合99mTc-MIBI与99mTcO-4显像鉴别甲状腺结节的临床价值

目的：探讨核医学99mTcO-4与99mTc-MIBI联合显像鉴别甲状腺结节良恶性的临床价值。方法对入选的40例甲状腺结节病例术前行甲状腺99mTcO-4显像、99mTc-MIBI显像，根据结节的99mTc-MIBI与99mTcO-4摄取值，计算99mTc-MIBI /99mTcO-4摄取比值（即M/T值）。根据术后病理，分析M/T值及血清人促甲状腺激素（hTSH）水平与结节良恶性的关系。结果40例中，5例甲状腺结节M/T比值≥2.0，病理结果为恶性结节（乳头状癌、滤泡状癌），与M/T值存在相关性（P〈0.05）；其余35例为良性结节（腺瘤、囊腺瘤），M/T值均〈2.0。联合甲状腺99mTcO-4和99mTc-MIBI显像诊断甲状腺恶性结节的灵敏度为100%，特异度为94.3%，准确率为95%。良性结节与hTSH水平增高有关（P〈0.05）。结论联合甲状腺99mTcO-4和99mTc-MIBI显像可对甲状腺结节的良恶性进行鉴别诊断，具有临床应用价值。

Clinical value of 99mTc-MIBI scintigraphy combined with 99mTcO-4 scintigraphy in differential diagnosis of benign and malignant thyroid nodules

Objective To investigate the clinical value of 99mTc-MIBI scintigraphy combined with 99mTcO-4 scintigraphy in differential diagnosis of benign and malignant thyroid nodules. Methods Forty cases with thyroid nodules were performed 99mTcO-4 scintigraphy and 99mTc-MIBI scintigraphy before surgery. The region of interest （ROI） uptake ratio of 99mTc-MIBI to 99mTcO4ˉ （M/T value） was calculated. The relationship between M/T value or blood human thyroid stimulating hormone （hTSH） level and benign and malignant nodules were analyzed according to the postoperative pathology. Results Among 40 cases, there were 5 cases with M/T value ≥2.0 and pathological results confirmed malignant （papillary carcinoma and follicular carcinoma）. The pathological result was correlated with M/T value （P〈0.05）. The rest 35 cases with M/T values 〈2.0 were diagnosed benign nodules （adenoma and cystadenoma）. The sensitivity was 100%, specificity was 94.3%, and accuracy was 95%. The benign nodule was associated with elevated hTSH level （P〈0.05）. Conclusion 99mTc-MIBI scintigraphy combined with 99mTcO-4 scintigraphy can differentially diagnose benign thyroid nodules from malignant ones, with application value in clinic.