CAJ | 학술논문

目的：探讨核医学99mTcO-4与99mTc-MIBI联合显像鉴别甲状腺结节良恶性的临床价值。方法对入选的40例甲状腺结节病例术前行甲状腺99mTcO-4显像、99mTc-MIBI显像，根据结节的99mTc-MIBI与99mTcO-4摄取值，计算99mTc-MIBI /99mTcO-4摄取比值（即M/T值）。根据术后病理，分析M/T值及血清人促甲状腺激素（hTSH）水平与结节良恶性的关系。结果40例中，5例甲状腺结节M/T比值≥2.0，病理结果为恶性结节（乳头状癌、滤泡状癌），与M/T值存在相关性（P<0.05）；其余35例为良性结节（腺瘤、囊腺瘤），M/T值均<2.0。联合甲状腺99mTcO-4和99mTc-MIBI显像诊断甲状腺恶性结节的灵敏度为100%，特异度为94.3%，准确率为95%。良性结节与hTSH水平增高有关（P<0.05）。结论联合甲状腺99mTcO-4和99mTc-MIBI显像可对甲状腺结节的良恶性进行鉴别诊断，具有临床应用价值。
목적：탐토핵의학99mTcO-4여99mTc-MIBI연합현상감별갑상선결절량악성적림상개치。방법대입선적40례갑상선결절병례술전행갑상선99mTcO-4현상、99mTc-MIBI현상，근거결절적99mTc-MIBI여99mTcO-4섭취치，계산99mTc-MIBI /99mTcO-4섭취비치（즉M/T치）。근거술후병리，분석M/T치급혈청인촉갑상선격소（hTSH）수평여결절량악성적관계。결과40례중，5례갑상선결절M/T비치≥2.0，병리결과위악성결절（유두상암、려포상암），여M/T치존재상관성（P<0.05）；기여35례위량성결절（선류、낭선류），M/T치균<2.0。연합갑상선99mTcO-4화99mTc-MIBI현상진단갑상선악성결절적령민도위100%，특이도위94.3%，준학솔위95%。량성결절여hTSH수평증고유관（P<0.05）。결론연합갑상선99mTcO-4화99mTc-MIBI현상가대갑상선결절적량악성진행감별진단，구유림상응용개치。
Objective To investigate the clinical value of 99mTc-MIBI scintigraphy combined with 99mTcO-4 scintigraphy in differential diagnosis of benign and malignant thyroid nodules. Methods Forty cases with thyroid nodules were performed 99mTcO-4 scintigraphy and 99mTc-MIBI scintigraphy before surgery. The region of interest (ROI) uptake ratio of 99mTc-MIBI to 99mTcO4ˉ (M/T value) was calculated. The relationship between M/T value or blood human thyroid stimulating hormone (hTSH) level and benign and malignant nodules were analyzed according to the postoperative pathology. Results Among 40 cases, there were 5 cases with M/T value ≥2.0 and pathological results confirmed malignant (papillary carcinoma and follicular carcinoma). The pathological result was correlated with M/T value (P<0.05). The rest 35 cases with M/T values <2.0 were diagnosed benign nodules (adenoma and cystadenoma). The sensitivity was 100%, specificity was 94.3%, and accuracy was 95%. The benign nodule was associated with elevated hTSH level (P<0.05). Conclusion 99mTc-MIBI scintigraphy combined with 99mTcO-4 scintigraphy can differentially diagnose benign thyroid nodules from malignant ones, with application value in clinic.