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目的探讨99 Tcm-MIBI显像对甲状腺单发结节良恶性鉴别诊断的临床价值。方法对78例99 TcmO4-甲状腺显像为单发“冷(凉)”结节患者进行99 Tcm-MIBI显像,采集30min(早期)及2h(晚期)双时相的静态图像,对显像结果进行定量分析并与病理结果对照,用受试者工作特征曲线(ROC)分析法评价99 Tcm-MIBI双时相显像对甲状腺恶性肿瘤的诊断效能。结果定量分析甲状腺癌组双时相的99 Tcm-MIBI摄取比值皆高于良性病变组(P<0.05);滞留指数无明显差异(P>0.05);早期摄取比值(ER)、晚期摄取比值(DR)及滞留指数(RI)ROC曲线下面积分别为0.777、0.891、0.650,从ROC曲线的界值点得到ER、DR及RI最佳界点为1.107、1.167、0.054,以DR 1.167作为诊断良恶性的阈值,99 Tcm-MIBI显像的灵敏度、特异性及准确性分别为75.0%、90.0%、89.7%。结论 99 Tcm-MIBI显像对甲状腺单发结节良恶性鉴别诊断有较大的临床应用价值。
Objective To investigate the clinical value of 99 Tcm-MIBI imaging in differential diagnosis of benign and malignant thyroid nodules. Methods 99 Tcm-MIBI imaging was performed in 78 patients with 99 TcmO4-thyroid gland in solitary cold “nodules”. The static images of the two phases of 30 min (early stage) and 2 h (late stage) were collected. The imaging results were quantitatively analyzed and compared with the pathological results. The diagnostic performance of 99 Tcm-MIBI dual-phase imaging in the diagnosis of thyroid malignant tumors was evaluated by receiver operating characteristic curve (ROC) analysis. Results The 99 Tcm-MIBI uptake ratio in the double-phase thyroid cancer patients was significantly higher than that in the benign lesion group (P <0.05). There was no significant difference in the retention index between the two groups (P> 0.05) DR) and retention index (ROC) were 0.777, 0.891 and 0.650, respectively. The best cutoff points of ER, DR and RI were 1.107,1.167,0.054 from the cut-off point of ROC curve, and DR 1.167 was the best The sensitivity, specificity and accuracy of 99 Tcm-MIBI imaging were 75.0%, 90.0% and 89.7% respectively for malignant threshold. Conclusion 99 Tcm-MIBI imaging of thyroid solitary nodules benign and malignant differential diagnosis of great clinical value.