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目的:进一步评价和探讨~(99m)Tc甲状腺功能显像及其定量分析方法的临床应用价值.方法:对有明确诊断结果的779例甲状腺功能显像病例进行了回顾性分析.结果:甲功正常组20min摄锝率大部在1%~4%之间(2,26±0.90).该方法诊断甲亢的准确率为94.0%(652/696),灵敏度为96.8%(182/188),特异性为92,9%(472/508);诊断甲低的准确率为86.5%(473/547),灵敏度为82.1%(32/39),特异性为86.8%(441/508).甲状腺炎组摄锝率高低变化很大;甲功显像结果与血中甲状腺激素测定结果的不一致率高达71%(22/31).51例摄锝率与摄碘率的相关性分析显示,20min摄锝率与3h摄碘率相关性最好.与摄碘串比较,虽然摄锝率的假阳性数较高,但漏诊数极低,总误诊率与摄碘率相近.结论:利用~(99m)Tc取代~(131)I进行甲状腺功能显像并进行定量分析,由于其独特的影像学特点和定量分析参数,不仅有助于对甲状腺功能状况的评价,而且在甲状腺炎症病变的诊断及甲亢患者疗效观察和预后判断方面亦有潜在价值.
Objective: To further evaluate and discuss the clinical value of ~ (99m) Tc thyroid imaging and its quantitative analysis.Methods: A retrospective analysis was performed on 779 cases of thyroid imaging with definite diagnosis.Results: In the normal group, the rate of uptake of technetium was mostly between 1% and 4% (2,26 ± 0.90). The diagnostic accuracy of this method was 94.0% (652/696) and the sensitivity was 96.8% (182/188), the specificity was 92.9% (472/508). The diagnostic accuracy of hypothyroidism was 86.5% (473/547), the sensitivity was 82.1% (32/39) and the specificity was 86 .8% (441/508) .The rate of uptake of technetium in thyroiditis group varied greatly, and the inconsistency rate of thyroid hormone and thyroid hormone in thyroiditis was as high as 71% (22/31) Correlation analysis showed that there was the best correlation between uptake rate of iodine in 20min and iodine uptake rate in 3h.Compared with iodine intake, although the false positive rate of uptake rate was high, the number of misdiagnosis was very low, the total misdiagnosis rate was The iodine uptake rates were close.Conclusion: The use of ~ (99m) Tc instead of ~ (131) I for thyroid function imaging and quantitative analysis, due to its unique imaging features and quantitative analysis of parameters, not only contribute to thyroid function status Evaluation, moreover Thyroid diagnosis of inflammatory lesions and patients with hyperthyroidism terms of efficacy and prognosis are also potential value.