~(99m)TcO_4~-甲状腺显像定量分析对甲状腺结节的鉴别诊断价值
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摘要
目的
探讨甲状腺显像定量分析对甲状腺良恶性结节的鉴别诊断价值,为患者的进一步治疗提供依据。
方法
对165例甲状腺结节患者进行甲状腺显像并依据术后病理结果分为良性结节组131例和恶性结节组34例。良性结节组分别按病理类型的不同进行分组。对良恶性结节两组患者,及良性结节组间患者的显像结果进行定量分析,测量①颈动脉-甲状腺通过时间(CTTT);②甲状腺结节部位与正常甲状腺部位的血流比(TNB/TB);③甲状腺结节部位与颈动脉部位的血流比(TNB/CAB);④摄锝指数(TN/SG);⑤摄锝比值(TN/T)。比较良恶性结节各项定量指标之间的差异及良性结节组间患者各项定量指标之间的差异。
结果
1、良恶结节组患者甲状腺显像各项指标的比较
(1)恶性结节组的CTTT值明显低于良性结节组,差别有显著统计学意义(P<0.01);恶性结节组的TNB/TB值、TNB/CAB值明显高于良性结节组,差别有显著统计学意义(P<0.01);恶性结节组的TN/T值明显低于良性结节组,差别有显著统计学意义(P<0.01)。
(2)恶性结节组的TN/SG值略低于良性结节组,差别无统计学意义(P>0.05)。
2、良性结节组间患者甲状腺显像各项指标的比较
良性结节组间CTTT值、TNB/TB值、TNB/CAB值、TN/SG值和TN/T值各项指标的比较均无显著统计学意义(P>0.05)。
3、应用ROC曲线分析结果显示,甲状腺动态显像定量指标CTTT值,TNB/TB值及TNB/CAB值与静态显像定量指标TN/T值诊断甲状腺结节良恶性的敏感度、特异度分别为82.4%,73.1%;85.4%,85.3%;80%,61.8%;85.3%,66.2%。甲状腺动态显像定量指标CTTT,TNB/TB值,TNB/CAB值分别与静态显像定量指标TN/T值联合诊断甲状腺结节良恶性的敏感度、特异度和准确度为分别为:67.65%、90.00%、85.36%;70.59%、93.08%、88.41%;50.00%、88.45%、80.49%。
结论
1、甲状腺显像定量分析对甲状腺结节良恶性的鉴别具有重要的临床价值。
2、甲状腺动态显像定量指标与甲状腺静态显像定量指标联合诊断对甲状腺结节良恶性鉴别具有一定的敏感度、特异度和准确度。
Objective
To investigate the value of quantitative analysis of thyroid imaging in the differential diagnosis of thyroid nodule and to provide the basis for further treatment of patients.
Methods
Thyroid imaging had been finished for 165 patients with thyroid nodules. According to the pathologic results, thyroid nodules were divided into 131 cases of benign nodules and 34 cases of malignant nodules. Groups of benign nodules were divided into different groups according to different pathological types respectively. The results were analyzed by quantitatively. Then we can obtain cervical arterial-thyroid transit time(CTTT); blood ratio of thyroid nodule and thyroid(TNB/TB); blood ratio of thyroid nodule and carotid artery(TNB/CAB); the ratio of thyroid nodule and salivary gland(TN/SG); the ratio of thyroid nodule and thyroid(TN/T). The difference of quantitative parameter between benign and malignant nodules were compared. The difference of quantitative parameter within the groups of benign nodules were compared.
Results
1、Comparing each parameter of thyroid imaging between the malignant and benign nodules
(1)The CTTT of malignant nodules was lower than that of benign nodules,there was significant difference(P<0.01). The TNB/TB and the TNB/CAB of malignant nodules were higher than that of benign nodules, there were significant differences(P<0.01). The TN/T of malignant nodules was lower than that of benign nodules,there was significant difference(P<0.01).
(2)The TN/SG of malignant nodules was lower than that of benign nodules, there was no significant difference(P>0.05).
2. Comparing each parameter of thyroid imaging within the groups of benign nodules
The CTTT, TNB/TB, TNB/CAB, TN /SG and TN/T were compared within the groups of benign nodules,there were no significant differences(P>0. 0 5).
3. ROC curve analysis showed that: The sensitivity and specificity of CTTT, TNB/TB, TNB/CAB and TN/T for diagnosis of thyroid nodule were 82.4%, 73.1%; 85.4%, 85.3%; 80%, 61.8%; 85.3%, 66.2% respectively. Combined quantitative parameter of CTTT, TNB/TB, TNB/CAB in thyroid dynamic imaging respectively with TN/T in thyroid static imaging, then the sensitivity, specificity and accuracy for diagnosis of benign and malignant nodules were 67.65%, 90.00%, 85.36%;70.59%, 93.08%, 88.41%;50.00%, 88.45%, 80.49% respectively.
Conclusions
1. Quantitative analysis of thyroid imaging has an important value for differential diagnosis thyroid nodule between benign and malignant.
2. It has a certain degree sensitivity, specificity and accuracy for differential diagnosis thyroid nodule if quantitative parameter in thyroid dynamic imaging combine with that in static imaging.
探讨甲状腺显像定量分析对甲状腺良恶性结节的鉴别诊断价值,为患者的进一步治疗提供依据。
方法
对165例甲状腺结节患者进行甲状腺显像并依据术后病理结果分为良性结节组131例和恶性结节组34例。良性结节组分别按病理类型的不同进行分组。对良恶性结节两组患者,及良性结节组间患者的显像结果进行定量分析,测量①颈动脉-甲状腺通过时间(CTTT);②甲状腺结节部位与正常甲状腺部位的血流比(TNB/TB);③甲状腺结节部位与颈动脉部位的血流比(TNB/CAB);④摄锝指数(TN/SG);⑤摄锝比值(TN/T)。比较良恶性结节各项定量指标之间的差异及良性结节组间患者各项定量指标之间的差异。
结果
1、良恶结节组患者甲状腺显像各项指标的比较
(1)恶性结节组的CTTT值明显低于良性结节组,差别有显著统计学意义(P<0.01);恶性结节组的TNB/TB值、TNB/CAB值明显高于良性结节组,差别有显著统计学意义(P<0.01);恶性结节组的TN/T值明显低于良性结节组,差别有显著统计学意义(P<0.01)。
(2)恶性结节组的TN/SG值略低于良性结节组,差别无统计学意义(P>0.05)。
2、良性结节组间患者甲状腺显像各项指标的比较
良性结节组间CTTT值、TNB/TB值、TNB/CAB值、TN/SG值和TN/T值各项指标的比较均无显著统计学意义(P>0.05)。
3、应用ROC曲线分析结果显示,甲状腺动态显像定量指标CTTT值,TNB/TB值及TNB/CAB值与静态显像定量指标TN/T值诊断甲状腺结节良恶性的敏感度、特异度分别为82.4%,73.1%;85.4%,85.3%;80%,61.8%;85.3%,66.2%。甲状腺动态显像定量指标CTTT,TNB/TB值,TNB/CAB值分别与静态显像定量指标TN/T值联合诊断甲状腺结节良恶性的敏感度、特异度和准确度为分别为:67.65%、90.00%、85.36%;70.59%、93.08%、88.41%;50.00%、88.45%、80.49%。
结论
1、甲状腺显像定量分析对甲状腺结节良恶性的鉴别具有重要的临床价值。
2、甲状腺动态显像定量指标与甲状腺静态显像定量指标联合诊断对甲状腺结节良恶性鉴别具有一定的敏感度、特异度和准确度。
Objective
To investigate the value of quantitative analysis of thyroid imaging in the differential diagnosis of thyroid nodule and to provide the basis for further treatment of patients.
Methods
Thyroid imaging had been finished for 165 patients with thyroid nodules. According to the pathologic results, thyroid nodules were divided into 131 cases of benign nodules and 34 cases of malignant nodules. Groups of benign nodules were divided into different groups according to different pathological types respectively. The results were analyzed by quantitatively. Then we can obtain cervical arterial-thyroid transit time(CTTT); blood ratio of thyroid nodule and thyroid(TNB/TB); blood ratio of thyroid nodule and carotid artery(TNB/CAB); the ratio of thyroid nodule and salivary gland(TN/SG); the ratio of thyroid nodule and thyroid(TN/T). The difference of quantitative parameter between benign and malignant nodules were compared. The difference of quantitative parameter within the groups of benign nodules were compared.
Results
1、Comparing each parameter of thyroid imaging between the malignant and benign nodules
(1)The CTTT of malignant nodules was lower than that of benign nodules,there was significant difference(P<0.01). The TNB/TB and the TNB/CAB of malignant nodules were higher than that of benign nodules, there were significant differences(P<0.01). The TN/T of malignant nodules was lower than that of benign nodules,there was significant difference(P<0.01).
(2)The TN/SG of malignant nodules was lower than that of benign nodules, there was no significant difference(P>0.05).
2. Comparing each parameter of thyroid imaging within the groups of benign nodules
The CTTT, TNB/TB, TNB/CAB, TN /SG and TN/T were compared within the groups of benign nodules,there were no significant differences(P>0. 0 5).
3. ROC curve analysis showed that: The sensitivity and specificity of CTTT, TNB/TB, TNB/CAB and TN/T for diagnosis of thyroid nodule were 82.4%, 73.1%; 85.4%, 85.3%; 80%, 61.8%; 85.3%, 66.2% respectively. Combined quantitative parameter of CTTT, TNB/TB, TNB/CAB in thyroid dynamic imaging respectively with TN/T in thyroid static imaging, then the sensitivity, specificity and accuracy for diagnosis of benign and malignant nodules were 67.65%, 90.00%, 85.36%;70.59%, 93.08%, 88.41%;50.00%, 88.45%, 80.49% respectively.
Conclusions
1. Quantitative analysis of thyroid imaging has an important value for differential diagnosis thyroid nodule between benign and malignant.
2. It has a certain degree sensitivity, specificity and accuracy for differential diagnosis thyroid nodule if quantitative parameter in thyroid dynamic imaging combine with that in static imaging.
引文
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