上海交通大学学报（医学版）

›› 2009, Vol. 29 ›› Issue (9): 1085-.

• 论著（临床研究） • 上一篇    下一篇

甲状腺癌术后患者颈淋巴结转移影像学比较研究

王 强1, 余永利1, 高秀丽1, 朱兆领2   

  1. 上海交通大学 第六人民医院　1. 核医学科, 2. 超声科, 上海 200233
  • 出版日期:2009-09-25 发布日期:2009-09-29
  • 通讯作者: 余永利, 电子信箱: yuyongli56@hotmail.com。
  • 作者简介:王强（1983—）, 男, 硕士生；电子信箱: wang-qiang1983@163.com。

Comparisons of imageology in postoperative cervical lymph node metastasis of thyroid carcinoma

WANG Qiang1, YU Yong-li1, GAO Xiu-li1, ZHU Zhao-ling2   

  1. 1. Department of Nuclear Medicine, 2. Department of Ultrasound, The Sixth People's Hospital, Shanghai Jiaotong University, Shanghai 200233, China
  • Online:2009-09-25 Published:2009-09-29

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摘要：

目的 探讨超声、99mTc甲氧基异丁基异腈（99mTc-MIBI）核素显像和131I全身扫描（131I-WBS）检测分化型甲状腺癌（DTC）术后患者颈淋巴结转移的临床价值。方法 117例DTC术后患者131I治疗前行99mTc-MIBI和超声检查，治疗6 d后行131I-WBS，结合血清甲状腺球蛋白（Tg）、131I-SPECT/CT、淋巴结穿刺活检及临床随访等手段确定颈淋巴结转移灶。结果 超声、99mTc-MIBI和131I-WBS诊断117例DTC术后患者颈淋巴结转移敏感度为76.5%、67.1%、83.5%（P<0.05），特异度为75.0%、78.1%、84.4%，准确度为76.1%、70.1%、83.8%（P<0.05）；三项联合检查的敏感度、特异度、准确度为98.8%、75.0%和92.3%。134个颈淋巴结转移灶检出率分别为超声75.4%、99mTc-MIBI 66.4%、131I-WBS 80.6%（P<0.05），前两项合并对26个131I-WBS假阴性显像灶检出率为96.2%。结论 超声、99mTc-MIBI和131I-WBS联合检查可显著提高DTC术后患者颈淋巴结转移诊断敏感度和准确度，前两项联合检查可提高131I-WBS假阴性显像灶检出率。

关键词: 甲状腺肿瘤, 淋巴结, 131I, 超声检查, 放射性核素显像

Abstract:

Objective To explore the clinical manifestations of ultrasonography（US）, 99mTc-methoxyisobutylisonitrile (99mTc-MIBI), and 131I whole body scan (131I-WBS) of patients with differentiated thyroid carcinoma（DTC）and cervical lymph node metastasis. Methods A total of 117 cases received examinations of US and 99mTc-MIBI before uses of 131I and received 131I-WBS after 6 d of 131I treatment. Combined with serum thyroglobulin（Tg）, 131I-SPECT/CT, lymph node biopsy and clinical follow-up of patients, cervical lymph node metastases were identified. Results In 117 patients, the sensitivity of US, 99mTc-MIBI and 131I-WBS were 76.5%, 67.1% and 83.5%（P<0.05）; the specificity of US, 99mTc-MIBI, and 131I-WBS were 75.0%, 78.1% and 84.4%; and the accuracy of US, 99mTc-MIBI and 131I-WBS were 76.1%, 70.1% and 83.8% (P<0.05), respectively. The total sensitivity, total specificity, and total accuracy of combination of the three examinations were 98.8%, 75.0% and 92.3%, respectively. Detection rates by US, 99mTc-MIBI, and 131I-WBS of 134 cervical lymph node metastasis were 75.4%, 66.4% and 80.6% (P<0.05). Combined US with 99mTc-MIBI, detection rate for 26 false-negative 131I-WBS imaging was 96.2%. Conclusion The combination of US, 99mTc-MIBI, and 131I-WBS could improve the sensitivity, specificity, and accuracy of post-operative cervical lymph node metastases of DTC. The combined results of US and 99mTc-MIBI could detect false-negative 131I-WBS imaging.

Key words: thyroid neoplasms, lymph node, 131I, ultrasonography, radionuclide imaging

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