^99mTc-MIBI甲状腺显像半定量分析鉴别甲状腺结节的价值

目的评价99mTc-MIBI甲状腺显像半定量分析法鉴别甲状腺结节的价值.材料和方法36例Na99mTcO4甲状腺显像为单发"冷结节"患者,行99mTc-MIBI甲状腺双时相显像,分别计算15和120min甲状腺结节摄取比值(ER、DR),以良性结节组的DR均值+标准差(0.90+0.21)为诊断恶性病变的阈值.结果手术证实良性病变22例,ER与DR值分别为0.89±0.33、0.90±0.21,恶性病变14例,ER和DR值分别为1.16±0.51、1.34±0.64,ER值两组间比较无差异(p＞0.05),DR两组间比较有显著性差异(p＜0.01).99mTc-MIBI甲状腺显像DR值诊断良恶性病变的灵敏度85.7%,特异性86.4%,阳性预测值80.0%,阴性预测值90.5%.结论99mTc-MIBI甲状腺显像半定量分析能较好的鉴别甲状腺结节的性质,DR比ED更有价值.

Significance of Dual-Phase 99mTc-MIBI Scintigrahy in the Differential Diagnosis of Thyroid Nodules

Purpose: Semiquantitative analysis of dual phase 99m Tc MIBI thyroid scintigraphy was used to distinguish thyroid nodules. Materials and Methods: 36 patients with thyroid nodules underwent 99m Tc pertechnetate and 99m Tc MIBI scintigraphy. 99m Tc MIBI scintigraphy was undertaken at 15 min(early) and 120 min(delayed) after injection. Semiquantitative analysis was performed using a lesion to non lesion ratio at early (ER) and delayed (DR) phase respectively. Results: Thyroid surgery and pathology proved 14 malignant and 22 benign lesions. Most malignant nodules had higher uptake of 99m Tc MIBI than normal tissues. There was no difference in ER but a significant difference in DR between malignant and benign lesions. Conclusion: The DR in dual phase 99m Tc MIBI thyroid scintigraphy is more valuable than ER in differentiating malignant from benign thyroid nodules.