Diagnostic value of 99mTcO4-SPECT/CT thyroid radionuclide imaging combined with ultrasound and TSH on the nature of thyroid nodules
Objective To differentiate the benign and malignant thyroid nodules by 99mTcO4-SPECT/CT radionuclide imaging,anatomical features of thyroid nodules,and ultrasound examination combined with thyroid stimulating hormone(TSH)level,so as to objec-tively evaluate the benign and malignant thyroid nodules and make early diagnosis of benign and malignant thyroid nodules.Methods99m TcO4-SPECT/CT thyroid radionuclide imaging,thyroid B-ultrasound and TSH were performed in 80 patients with 92 thy-roid nodules in our hospital.The diagnostic efficacy of different methods and combined examinations for thyroid nodules was analyzed retro-spectively.Results Among the 92 nodules,74 were benign and 18 were malignant.99mTcO4-SPECT/CT thyroid imaging had higher sensi-tivity(77.8％),lower specificity(70.2％),lower accuracy(71.7％),higher false positive rate(29.7％)and lower false negative rate(22.2％)than ultrasonography.The sensitivity,specificity,accuracy,false positive rate and false negative rate were statistically significant(P＜0.05);There was no significant difference in accuracy(P＞0.05).Compared with ultrasonography,99mTcO4-SPECT/CT thyroid im-aging had higher sensitivity,lower specificity and accuracy,higher false positive rate and lower false negative rate.There were significant differences in sensitivity,specificity,accuracy,false positive rate and false negative rate between them(P＜0.05);There was no significant difference in accuracy between the two methods(P＞0.05).The sensitivity(88.9％),specificity(87.8％),accuracy(81.5％),false positive rate(12.1％)and false negative rate(11.1％)of thyroid imaging combined with ultrasonography.99m TcO4-SPECT/CT were higher than those of radionuclide and ultrasonography alone;There was significant difference in specificity,accuracy and false positive rate between combined and single nuclides(P＜0.05),but no significant difference in sensitivity and false negative rate(P＞0.05);There were significant differences in sensitivity,accuracy and false negative rate between combined ultrasound and single ultrasound(P＜0.05);There was no significant difference between specificity and false positive rate(P＞0.05).Conclusion Ultrasound can be used as the first choice for thyroid nodules,with high specificity but low sensitivity.99mTcO4-SPECT/CT thyroid imaging can provide anatomical information as well as functional and metabolic information;Serum TSH can provide an important reference for the differentiation of benign and malig-nant thyroid nodules,especially for patients with radionuclide cold nodules and ultrasound solid nodules.It is of great significance to com-bine the three to judge the nature of thyroid nodules and provide an appropriate clinical treatment plan.
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