摘要
目的分析SPECT/CT精准定量对甲状腺结节良恶性鉴别诊断的应用价值。方法选取经超声确诊的8l例甲状腺结节患者,所有患者行^(99m)TcO4-显像及定量SPECT/CT检查,结果为“凉结节”及“冷结节”患者次日行^(99m)Tc-MIBI显像及定量SPECT/CT。勾画感兴趣区(ROI)获取甲状腺摄锝率及结节的标准摄取值(SUV)。上述检查完成后行手术治疗并以术后病理结果为金标准比较良恶性结节各参数间的差异。绘制ROC曲线获取SUV值的诊断界值,与^(99m)TcO4-及^(99m)Tc-MIBI显像结果作比较,评价诊断效能。结果81例患者,术后病理结果显示甲状腺恶性结节35例,良性结节46例,良性组与恶性组甲状腺摄锝率及结节的标准摄取值差异有统计学意义(P<0.05)。^(99m)TcO4-结合^(99m)Tc-MIBI显像诊断灵敏度、特异度、准确性为41.6%、68.8%、56.8%。ROC曲线结果示^(99m)TcO4-SUVmax及SUVavg诊断界值、曲线下面积(AUC)、敏感度、特异度、准确性分别为0.808、43.83 g/ml、100.0%、51.1%、72.8%及0.808、30.08 g/ml、94.1%、57.4%、74.1%。^(99m)Tc-MIBI SUVmax及SUVavg的诊断界值、AUC、敏感度、特异度、准确性分别为0.899、2.24 g/ml、79.4%、92.9%、85.4%及0.816、1.37 g/ml、88.2%、71.4%、82.2%。结论精准定量SPECT/CT对甲状腺结节的良恶性诊断具有较高的准确性,^(99m)Tc-MIBI SUVmax以2.24 g/ml作为诊断界值时的诊断效能最高。
Objective To analyze the value of accruate quantitative SPECT/CT in differential diagnosis of benign and malignant thyroid nodules.Methods 81 patients with thyroid nodules diagnosed by ultrasound were selected.All patients were examined by^(99m)TcO4-imaging and quantitative SPECT/CT,cool and cold nodules were performed^(99m)Tc-MIBI imaging and quantitative SPECT/CT on the next day.Region of interest(ROI)was used to obtain thyroid uptake rate and nodule′s standard uptake value.The difference between the parameters of benign and malignant nodules was compared based on patient′s postoperative pathology.The diagnostic thresholds of standardized uptake value(SUV)were obtained by drawing the ROC curves,and the diagnostic efficacy was evaluated by comparing with the results of^(99m)TcO4-and^(99m)Tc-MIBI imaging.Results In 81 patients,postoperative pathology showed that 35 thyroid nodules were malignantand 46 thyroid nodules were benign.The difference of thyroid uptake rate and nodule′s standard uptake value between benign and malignant groups was statistically significant(P<0.05).The diagnostic sensitivity,specificity and accuracy of^(99m)TcO4-combined with^(99m)Tc-MIBI imaging were 41.6%,68.8%,56.8%respectively.ROC curve results showed the diagnostic thresholds,area under curve(AUC),sensitivity,specificity,accuracy of^(99m)TcO4-SUVmax and SUVavg were 43.83 g/ml,0.808,100%,51.1%,72.8%and 30.08 g/ml,0.808,94.1%,57.4%,74.1%respectively.The diagnostic thresholds,AUC,sensitivity,specificity,accuracy of^(99m)Tc-MIBI SUVmax and SUVavg were 2.24 g/ml,0.899,79.4%,92.9%,85.4%and 1.37 g/ml,0.816,88.2%,71.4%,82.2%respectively.Conclusion Accurate quantitative SPECT/CT has high accuracy in diagnosis of benign and malignant thyroid nodules,and^(99m)Tc-MIBI SUVmax has the highest diagnostic efficiency when the diagnostic threshold is 2.24 g/ml.
作者
朱英杰
徐慧琴
吴涛
叶雨生
刘斌
朱干
谯凤
Zhu Yingjie;Xu Huiqin;Wu Tao(Dept of Nuclear Medicine,The First Affiliated Hospital of Anhui Medical University,Hefei 230022)
出处
《安徽医科大学学报》
CAS
北大核心
2021年第12期1991-1995,共5页
Acta Universitatis Medicinalis Anhui
基金
国家自然科学基金(编号:81971643)
江苏省分子核医学重点实验室(编号:KF201901)。
