SPECT/CT融合图像诊断胸骨后甲状腺肿的临床价值-现代医学

SPECT/CT融合图像诊断胸骨后甲状腺肿的临床价值

作者：陈兰兰

单位：沈阳军区总医院

分类号：

出版年·卷·期（页码）：2014··第一期（0-）

摘要：

目的: 探讨SPECT/CT同机融合图像鉴别诊断胸骨后甲状腺肿的临床价值。方法：回顾分析58例胸片发现可疑上纵隔肿物并拟诊胸骨后甲状腺肿的患者，并分别行CT扫描、SPECT/CT同机融合图像处理，依据术后病理，比较CT和SPECT/CT两种方法诊断胸骨后甲状腺肿的差异。结果：58例可疑胸骨后甲状腺肿患者中CT诊断45例为胸骨后甲状腺肿，13例被诊断胸骨后肿物为非甲状腺组织； SPECT/CT同机融合图像诊断35例为胸骨后甲状腺肿，23例被诊断胸骨后肿物为非甲状腺组织，后经手术证实33例诊断的胸骨后甲状腺肿为确定性诊断，25例诊断为非甲状腺组织；CT和SPECT/CT诊断胸骨后甲状腺肿灵敏度、特异性、准确率分别为：100%和94.3%、65.2%和100%、86.2%和96.6%，其误诊率、漏诊率、阳性结果预测值、阴性结果预测值分别为：34.5%和0、0和5.7%、82.4 % 和100%、100%和92.0%。结论：SPECT/CT同机融合图像诊断胸骨后甲状腺肿特异性、准确率、阳性结果预测值高均高于CT诊断，灵敏度、阴性结果预测值较CT略低，并且误诊率为零，漏诊率非常低。

Objective: To evaluate the clinical value of the SPECT / CT fusion imaging in differential diagnosis of substernal struma. Methods: Retrospectively analysis 58 patients with suspected substernal struma ,who were found mediastinal goiter by chest X-ray. CT and SPECT / CT fusion imaging were performed respectively, the differences of the diagnostic coincidence were compared based on pathology performed after operations. Results: 45 in 58 patients were confirmed as substernal struma by CT; 35 patients diagnosed as substernal struma by SPECT/CT fusion imaging ,after the operation; 33 patients were determined as substernal struma.The accuracy rates of substernal struma diagnosis by CT and SPECT/CT were 100% and 94.3%,65.2% and 100%,86.2% and 96.6%，the positive prediction value and negative value of the results were 82.4% and 100%, 100% and 92.0%; Conclusion: By SPECT / CT fusion imaging, specificity, diagnostic accuracy rates and the positive prediction value of substernal struma diagnosis were higher than that by CT, the sensitivityand negative prediction value were lower.

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