99Tcm-MIBI甲状腺显像鉴别甲状腺结节良恶性再认识

目的评价^99Tc^m-甲氧基异丁基异腈（MIBI）甲状腺亲肿瘤显像鉴别甲状腺结节良恶性的临床价值。方法106例甲状腺结节手术患者中101例先进行了甲状腺结节常^99Tc^mO4^-显像；106例患者均静脉注射^99Tc^m-MIBI 370 MBq后进行15min早期和2h延迟显像，结果与病理检查结果对比。结果13例甲状腺恶性肿瘤中的5例、93例良性结节中的23例^99Tc^m-MIBI显像阳性。^99Tc^m-MIBI显像诊断甲状腺恶性肿瘤的灵敏度为38．5％，特异性为75．3％，准确性为70．8％。甲状腺良恶性肿瘤显像的阳性率差异无显著性（x^2=0．49，P〉0．05）。结论^99Tc^m-MIBI显像不能鉴别甲状腺结节的良恶性，其临床意义有限。

Reconsideration of the use of 99Tcm-MIBI thyroid imaging for detection of thyroid malignancy in thyroid nodules

Objective To reconsider the use of~(99)Tc~m-methoxyisobutylisonitrile(MIBI)thyroid im- aging for detection of thyroid malignancy in thyroid nodules.Methods One hundred and one of 106 thyroid nodules patients underwent routine ~(99)Tc~mO_4~- scan first,then after injection of 370 MBq ~(99)Tc~m-MIBI dual- phase(15 min and 2h)thyroid imaging was performed in all 106 patients within 1 week.After operation the result of thyroid imaging was compared with pathologic findings.Results Among 5/13 cases of thyroid malignancy and 23/93 of benign nodules,~(99)Tc~m-MIBI imaging showed positive result.The sensitivity,spe- cificity,positive predictive value and negative predictive value of ~(99)Tc~m-MIBI scintigraphy were 38.5%, 75.3%,17.9% and 89.7%,respectively.No statistics difference was found between benign and malig- nant thyroid nodules(x~2=0.49,P>0.05).Conclusions ~(99)Tc~m-MIBI thyroid imaging is not specific for thyroid malignancy.Thereby its clinical value is limited.