| 刘长江,董燕玉,胡翔,邓洪,王才顺.99Tcm-MIBI SPECT/CT诊断甲状腺乳头状癌术后彩色多普勒超声疑似颈部淋巴结转移[J].中国医学影像技术,2020,36(10):1456~1460 |
| 99Tcm-MIBI SPECT/CT诊断甲状腺乳头状癌术后彩色多普勒超声疑似颈部淋巴结转移 |
| 99Tcm-MIBI SPECT/CT in diagnosis of color Doppler ultrasound uncertain cervical lymph node metastasis after surgical resection of papillary thyroid carcinoma |
| 投稿时间：2019-06-18 修订日期：2020-05-10 |
| DOI：10.13929/j.issn.1003-3289.2020.10.004 |
| 中文关键词: 甲状腺癌,乳头状 淋巴结转移 体层摄影术,发射型计算机,单光子 体层摄影术,X线计算机 99m锝甲氧基异丁基异腈 |
| 英文关键词:thyroid cancer, papillary lymphatic metastasis tomography, emission-computed, single-photon tomography, X-ray computed technetium Tc 99m sestamibi |
| 基金项目:黔西南州科技计划（2015-1-68）。 |
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| 中文摘要: |
| 目的 评估99Tcm-MIBI SPECT/CT诊断甲状腺乳头状癌（PTC）术后彩色多普勒超声（CDUS）疑似颈部淋巴结转移的价值。方法 收集31例PTC术后CDUS疑似颈部淋巴结转移患者，均于术后1个月内接受颈部99Tcm-MIBI SPECT/CT扫描，之后15天内接受颈部131I SPECT/CT扫描。观察99Tcm-MIBI SPECT/CT对于PTC术后颈部淋巴结转移的诊断效率。结果 31例中，6例（6/31，19.35%）存在颈部淋巴结转移。99Tcm-MIBI SPECT/CT对PTC术后颈部淋巴结转移的敏感度、特异度、准确率、阳性预测值和阴性预测值分别为66.67%（4/6）、96.00%（24/25）、90.32%（28/31）、80.00%（4/5）和92.31%（24/26）。共确定14个颈部淋巴结转移灶，99Tcm-MIBI SPECT/CT诊断敏感度和阳性预测值分别为71.43%（10/14）和83.33%（10/12），首次131I SPECT/CT为28.57%（4/14）和100%（4/4），99Tcm-MIBI SPECT/CT的敏感度高于131I SPECT/CT（χ2=5.14，P<0.05），其阳性预测值与首次131I SPECT/CT差异无统计学意义（Fisher精确概率法，P>0.05）。结论 99Tcm-MIBI SPECT/CT能确定大部分PTC颈部淋巴结转移灶，为判断131I SPECT/CT和CDUS疑似淋巴结转移提供更多信息。 |
| 英文摘要: |
| Objective To explore the value of 99Tcm-MIBI SPECT/CT in diagnosis of color Doppler ultrasound (CDUS) uncertain cervical lymph node metastasis after surgical resection of papillary thyroid carcinoma (PTC). Methods A total of 31 patients with CDUS uncertain cervical lymph node metastasis after surgical resection of PTC were collected. 99Tcm-MIBI SPECT/CT of the neck was performed one month within operation, then 99Tcm-MIBI SPECT/CT, 131I SPECT/CT of the neck were performed within 15 days. The diagnostic efficiency of 99Tcm-MIBI SPECT/CT was observed. Results Among 31 PTC patients, cervical lymph node metastases were detected in 6 (6/31, 19.35%) patients. The sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of 99Tcm-MIBI SPECT/CT was 66.67% (4/6), 96.00% (24/25), 90.32% (28/31), 80.00% (4/5) and 92.31% (24/26), respectively. Totally 14 cervical metastatic lesions were found, the sensitivity and PPV of 99Tcm-MIBI SPECT/CT in diagnosis of cervical metastatic lesions was 71.43% (10/14) and 83.33% (10/12), of 131I SPECT/CT was 28.57% (4/14) and 100% (4/4), respectively. 99Tcm-MIBI SPECT/CT showed higher sensitivity than 131I SPECT/CT (χ2=5.14, P<0.05) and similar PPV (Fisher exact test, P>0.05). Conclusion 99Tcm-MIBI SPECT/CT could be used to correctly localize most cervical lymph node metastasis of PTC, providing further information for judging 131I SPECT/CT and CDUS uncertain cervical lymph node metastases in postoperative PTC patients. |
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