99mTctetrofosmin显像在老年人甲状腺“冷结节”性质判定中的价值.docVIP

99mTctetrofosmin显像在老年人甲状腺“冷结节”性质判定中的价值 作者：张浩然 赵劼 高识 马庆杰 孙辉 【摘要】 目的 对99m锝1,2双〔双(2乙氧乙基)膦基〕乙烷（99mTctetrofosmin，99mTcTF）显像与颈部彩色多普勒超声（color doppler ultrasonography，CDU）检查对甲状腺“冷结节”性质判定的结果进行对比分析，以明确99mTcTF显像在判定甲状腺“冷结节”性质中的价值。方法 选择经99mTcO-4显像证实为甲状腺“冷结节”60岁以上的患者60例，以术后病理结果为标准，分别对99mTcTF显像及颈部CDU检查在96处甲状腺“冷结节”、62处直径＞1 cm的甲状腺“冷结节”中的判定结果进行对比分析。结果 病理结果示96处甲状腺“冷结节”中良性52处，恶性44处。颈部CDU准确率为79.17%，99mTcTF显像准确率为77.08%，两种手段间准确率比较无显著差异（P0.05）。病理结果示直径＞1 cm的62处甲状腺“冷结节”中良性34处、恶性28处。颈部CDU准确率为79.03%，较其在甲状腺“冷结节”中判定的准确率无显著性差异（P0.05）；99mTcTF显像准确率为91.94%，较其在甲状腺“冷结节”中，判定的准确率增高（P0.05）。99mTcTF显像判定准确率高于颈部CDU（P0.05）。结论 99mTcTF显像在直径较大的甲状腺“冷结节”的性质判定准确率优于颈部CDU检查。 【关键词】 甲状腺；“冷结节”；核素显像；1，2双〔双（2乙氧乙基）膦〕 【Abstract】 Objective To identify the diagnosis value of 99mTctetrofosmin imaging in thyroid “cold nodule” by comparing the diagnostic results of 99mTctetrofosmin imaging and neck Color Doppler Ultrasonography (CDU). Methods 60 patients with thyroid “cold nodule” determined by 99mTcO-4 imaging were chosen. Regarded pathological result as the standard and compared diagnostic value of 99mTctetrofosmin imaging and neck CDU in analyzing 96 thyroid “cold nodules”，62 thyroid “cold nodules” with diameter greater than 1 cm respectively. Results There were 52 cases of benign，44 cases of malignancy in 96 thyroid “cold nodules”. The accurate of neck CDU and 99mTcTF were 79.17% and 77.08% respectively，there was no significant difference（P＞0.05）.There were 34 cases of benign, 28 cases of malignancy in 62 cases of thyroid “cold nodule” with diameter＞ 1cm. The accurate of neck CDU was 79.03%, there was no significant difference（P＞0.05）comparing that in thyroid “cold nodule”. The accurate of 99mTcTF was 91.94%, higher than that in thyroid “cold nodule”（P＜0.05）and that of neck CDU（P＜0.05）. Conclusions 99mTcTF imaging is more sensitive in large diameter thyroid “cold nodule”. 【Key words】Thyroid；“Cold nodule”；Radionuclide imaging；Tetrofosmin 　　甲状腺癌在内分泌系统恶性肿瘤中排第一位，约占全身所有恶性肿瘤的1%～1.5%，近年来有增高的趋势〔1，2〕。约有近95%的甲状腺癌表现为“冷结节”，