摘要
目的:比较4种靶/非靶比值(target-to-nontarget ratio,T/NT)的诊断价值,选择更佳评估甲状腺相关性眼病(thyroid associated ophthalmopathy,TAO)活动性的T/NT以及判断TAO炎性活动性的阈值。方法:回顾性分析初诊为TAO的患者29例(58只眼),均行^(99m)Tc-DTPA眼眶单光子发射计算机断层显像/计算机断层扫描(single photon emission computed tomography/computed tomography,SPECT/CT),根据临床活动性评分(clinical activity score,CAS)分为活动期组18例(36只眼),非活动期组11例(22只眼);同时设置对照组9例(18只眼);分别计算每个眼眶的眼眶/枕叶脑组织放射性计数比值(T/NT1)、眼眶/枕骨放射性计数比值(T/NT2)、眼眶/丘脑放射性计数比值(T/NT3)和眼眶/小脑放射性计数比值(T/NT4),与CAS行Spearman秩相关分析和受试者工作特征(receiver operating characteristic,ROC)曲线分析。结果:T/NT1和T/NT2与CAS有相关性(r_1=0.873,r_2=0.527;P<0.001),T/NT1与CAS评分相关性更好;T/NT3和T/NT4与CAS之间无相关性(r_3=0.039,r_4=0.090;均P>0.05);T/NT1的ROC曲线下面积为0.860,T/NT2的ROC曲线下面积为0.581,故T/NT1对TAO活动性评估的准确性更高;T/NT1=9.74为判断TAO患者活动性的阈值。结论:T/NT1与CAS有更好的相关性,对于TAO活动性评估有更高的诊断价值,SPECT/CT同机融合显像解剖定位更为精确。
Objective： To compare diagnostic value of 4 choose a better one to assess thyroid associated kinds of target-to-nontarget ratio （T/NT）, and to ophthalmopathy （TAO） activity. Methods： The clinical data were collected for 29 newly-diagnosed patients （58 eyes） with TAO who underwent orbital 99mTc-DTPA single photon emission computed tomography/computedtomography （SPECT/CT） fusion images according to the clinical activity score （CAS）. They were divided into an active group （18 cases, 36 eyes）, an inactive group （11 cases, 22 eyes）, and a control group （9 cases, 18 eyes）. Diagnostic value of orbital^occipital lobe radioactive uptake count ratio （T/NT1）, orbital/occipital radioactive uptake count ratio （T/NT2）, orbital/thalamus radioactive uptake count ratio （T/NT3）, and orbital/cerebellar radioactivity uptake count ratio （T/NT4） were calculated, and the CAS of Spearman rank correlation and receiver operating characteristic （ROC） curve were analyzed. Results： T/NT1, T/NT2 and CAS were correlated （r1=0.873, r2=0.527; P〈0.001）, with the better correlation between T/NT1 and CAS and there was no correlation between T/NT3, T/NT4 and CAS （r3=0.039, r4=0.090; P〉0.0S）. Area under the ROC curve of T/NT1 was 0.860, area under the ROC curve of T/NT2 was 0.581, and the accuracy for T/NT1 on TAO activity was good. T/ NT1 =9.74 could be used as active threshold for iudge of TAO in patients. Condusion： There is a good correlation between T/NT1 and CAS. TAO activity assessment possesses high diagnostic value, and SPECT/CT together with imaging anatomical location is more accurate.
作者
蒋承志
李新辉
邓豪余
刘进言
黄金
刘丹
许雪亮
JIANG Chengzhi;LI Xinhui;DEND Haoyu;LIU Jinyan;HUANG Jin;LIU Dan;XU Xueliang(Department of Nuclear Medicine;Department of Ophthalmologyj Xiangya Hospital,Central South University,Changsha 410008,China)
出处
《中南大学学报（医学版）》
CAS
CSCD
北大核心
2018年第8期869-874,共6页
Journal of Central South University ：Medical Science
