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目的探讨99Tcm-HL91甲状腺肿瘤阳性显像的可行性,分析其诊断效能。方法对6例正常自愿者与70例经甲状腺扫描证实的甲状腺孤立冷结节患者进行99Tcm-HL91显像研究,用肉眼法与半定量分析法对诊断效能予以评价。结果(1)99Tcm-HL91在正常人甲状腺内几乎不摄取,4 h颈部占全身放射性约1.18%;(2)甲状腺99Tcm-HL91乏氧显像结果有4种类型,即热、温、冷结节与不显影,热结节主要见于甲状腺癌;(3)甲状腺癌T/N比值随时间有升高趋势,4 h显示了较好的显像品质;(4)肉眼与半定量法(阈值)判断对甲状腺癌诊断的灵敏度,特异性和准确性分别为77.78%、92.31%、88.57%;88.89%、92.31%、91.42%(T/N比值≥1.08)。2种判断方法之间比较无显著性差异(P>0.05)。结论(1)99Tcm-HL91甲状腺乏氧显像能够鉴别甲状腺孤立冷结节的性质,肉眼法与半定量分析法对甲状腺肿瘤具有相同的诊断效能。(2)推荐用4 h恶性组T/N比值的x-s为诊断阈值,对于进一步判断甲状腺肿瘤性质有重要临床价值。
Objective To investigate the feasibility of 99Tcm-HL91 thyroid tumor positive imaging and analyze its diagnostic efficacy. Methods 99Tcm-HL91 imaging was performed on 6 normal volunteers and 70 thyroid gland isolated cold nodules confirmed by thyroid scan. The diagnostic efficacy was evaluated by both macroscopic and semi-quantitative methods. RESULTS: (1) 99Tcm-HL91 was almost not uptake in the normal thyroid and about 1.18% of the whole body was radioactive in 4 hours. (2) There were 4 types of 99Tcm-HL91 hypoxic imaging results in the thyroid, namely hot, warm and cold (3) The T / N ratio of thyroid cancer increased with time, showing good imaging quality at 4 hours; (4) The gross and semi-quantitative Threshold) were 77.78%, 92.31%, 88.57%, 88.89%, 92.31%, 91.42% (T / N ratio≥1.08) respectively. There was no significant difference between the two methods (P> 0.05). Conclusion (1) 99Tcm-HL91 thyroid hypoxia imaging can identify the nature of isolated cold nodules in thyroid gland, macroscopic and semi-quantitative analysis of thyroid tumors have the same diagnostic efficacy. (2) It is recommended to use the 4-h malignancy T-N ratio of x-s as the diagnostic threshold for further judging the nature of thyroid tumors have important clinical value.