SPECT／CT融合图像诊断胸骨后甲状腺肿的临床价值

目的： 探讨SPECT/CT同机融合图像鉴别诊断胸骨后甲状腺肿的临床价值。方法：回顾分析58例胸片发现可疑上纵隔肿物并拟诊胸骨后甲状腺肿的患者，并分别行CT扫描、SPECT/CT同机融合图像处理，依据术后病理，比较CT和SPECT/CT两种方法诊断胸骨后甲状腺肿的差异。结果：58例可疑胸骨后甲状腺肿患者中CT诊断45例为胸骨后甲状腺肿，13例被诊断胸骨后肿物为非甲状腺组织； SPECT/CT同机融合图像诊断35例为胸骨后甲状腺肿，23例被诊断胸骨后肿物为非甲状腺组织，后经手术证实33例诊断的胸骨后甲状腺肿为确定性诊断，25例诊断为非甲状腺组织；CT和SPECT/CT诊断胸骨后甲状腺肿灵敏度、特异性、准确率分别为：100%和94.3%、65.2%和100%、86.2%和96.6%，其误诊率、漏诊率、阳性结果预测值、阴性结果预测值分别为：34.5%和0、0和5.7%、82.4 % 和100%、100%和92.0%。结论：SPECT/CT同机融合图像诊断胸骨后甲状腺肿特异性、准确率、阳性结果预测值高均高于CT诊断，灵敏度、阴性结果预测值较CT略低，并且误诊率为零，漏诊率非常低。

The clinical value of SPECT/CT fusion imaging in the diagnosis of substernal struma

Objective： To evaluate the clinical value of the SPECT / CT fusion imaging in differential diagnosis of substernal struma. Methods： Retrospectively analysis 58 patients with suspected substernal struma ,who were found mediastinal goiter by chest X-ray. CT and SPECT / CT fusion imaging were performed respectively, the differences of the diagnostic coincidence were compared based on pathology performed after operations. Results： 45 in 58 patients were confirmed as substernal struma by CT; 35 patients diagnosed as substernal struma by SPECT/CT fusion imaging ,after the operation; 33 patients were determined as substernal struma.The accuracy rates of substernal struma diagnosis by CT and SPECT/CT were 100% and 94.3%,65.2% and 100%,86.2% and 96.6%,the positive prediction value and negative value of the results were 82.4% and 100%, 100% and 92.0%; Conclusion： By SPECT / CT fusion imaging, specificity, diagnostic accuracy rates and the positive prediction value of substernal struma diagnosis were higher than that by CT, the sensitivityand negative prediction value were lower.