论文部分内容阅读
[目的]探讨SPECT/CT多模态显像联合颈部超声及血清甲状腺球蛋白(Tg)对分化型甲状腺癌(DTC)~(131)I治疗后颈部淋巴结转移的诊断价值。[方法 ]68例DTC术后患者,~(131)I治疗前行血清Tg及颈部超声检查,~(131)I治疗后5d分别行WBS及SPECT/CT多模态显像,联合颈部超声及Tg,以病理及随访结果为诊断标准,采用χ~2检验对两种显像方法进行比较。[结果]68例DTC患者,颈部病灶共180个,SPECT/CT多模态显像检出率96.67%(174/180),WBS检出率90.56%(163/180,),差异有统计学意义(χ~2=5.26,P=0.018)。单独联合超声或Tg,以及同时联合超声和Tg时,~(131)I-SPECT/CT多模态显像对DTC术后颈部淋巴结转移灶的诊断价值与~(131)I-WBS比较差异均有统计学意义(χ~2=34.065,P<0.001;χ~2=38.246,P<0.001;χ~2=19.431,P<0.001)。灵敏度、特异性及准确性方面,~(131)I-SPECT/CT多模态显像联合超声分别为94.57%、94.31%、94.44%,~(131)I-WBS联合超声分别为78.26%、60.23%、69.44%;~(131)I-SPECT/CT多模态显像联合Tg分别为94.57%、92.05%、93.33%,~(131)I-WBS联合Tg分别为64.13%、67.05%、65.56%;~(131)I-SPECT/CT多模态显像联合超声及Tg分别为94.57%、97.73%、96.11%,~(131)I-WBS联合超声及Tg分别为66.30%、93.18%、79.44%。[结论]SPECT/CT多模态显像联合超声及血清Tg能提高DTC患者~(131)I治疗后颈部淋巴结转移病灶的检出率,明显提高颈部淋巴结转移诊断的灵敏度、特异性及准确性。
[Objective] To investigate the diagnostic value of SPECT / CT multimodal imaging combined with cervical ultrasonography and serum thyroglobulin (Tg) in diagnosis of cervical lymph node metastasis after differentiated thyroid cancer (DTC) ~ (131) I treatment. [Method] Sixty-eight patients with DTC were treated with ~ (131) I serum Tg and neck ultrasound examination, WBS and SPECT / CT multimodal imaging 5 days after ~ (131) I treatment, combined with neck Ultrasound and Tg, with the pathological and follow-up results as the diagnostic criteria, the two imaging methods were compared using χ ~ 2 test. [Results] There were 180 cervical lesions in 68 cases of DTC. The detection rate of SPECT / CT multimodality imaging was 96.67% (174/180) and the detection rate of WBS was 90.56% (163/180) Significance (χ ~ 2 = 5.26, P = 0.018). The diagnostic value of ~ (131) I-SPECT / CT multimodality imaging in the diagnosis of cervical lymph node metastases after DTC was significantly lower than that of ~ (131) I-WBS when combined with ultrasound or Tg alone, combined with ultrasound and Tg. (Χ ~ 2 = 34.065, P <0.001; χ ~ 2 = 38.246, P <0.001; χ ~ 2 = 19.431, P <0.001). The sensitivity, specificity and accuracy of ~ (131) I-SPECT / CT multimodality imaging combined with ultrasound were 94.57%, 94.31%, 94.44%, and 131 I-WBS combined ultrasound were 78.26% The combined Tg of ~ (131) I-SPECT / CT multimodal imaging were 94.57%, 92.05%, 93.33%, and 131.13 I-WBS with Tg of 64.13% and 67.05%, respectively The combined ultrasound and Tg of ~ (131) I-SPECT / CT multimodal imaging were 94.57%, 97.73%, 96.11%, 131 I-WBS combined with ultrasound and Tg respectively 66.30%, 93.18% , 79.44%. [Conclusion] SPECT / CT multimodal imaging combined with ultrasound and serum Tg can improve the detection rate of cervical lymph node metastasis after 131I treatment in DTC patients and significantly improve the sensitivity and specificity of diagnosis of cervical lymph node metastasis accuracy.