摘要
目的探讨99mTc-奥曲肽眼眶显像对甲状腺相关性眼病(TAO)炎症活动度的评价效果。方法对41例TAO患者(82只眼)行99mTc-奥曲肽眼眶SPECT/CT融合显像,并以10例无眼部疾病的肺癌患者(20只眼)作为对照。以临床活动性评分(CAS)作为标准,计算出其眼眶99mTc-奥曲肽摄取比值(UR)。结果按阅片结果将82只眼分为阳性组(n=44)和阴性组(n=38),阳性组平均CAS为3.60±0.99,阴性组平均CAS为0.97±1.19,阳性组平均CAS显著高于阴性组平均CAS(P<0.05),阅片结果与CAS的一致性为中等程度;TAO患者平均UR为1.54±0.50。按CAS将82只眼分为活动期组(CAS≥3)和非活动期组(CAS<3),活动期组(n=42)平均UR为1.80±0.49,平均CAS为3.81±0.99,非活动期组(n=40)平均UR为1.23±0.32,平均CAS为0.74±0.89,非活动期组显著低于活动期组(P<0.05);UR与CAS呈中度相关(r=0.61,P<0.05),ROC曲线下面积为0.803,区分活动期及非活动期TAO的UR阈值为1.38,其灵敏度为71.43%,特异度为80.00%。对照组平均UR为1.03±0.09,显著低于TAO组(P<0.05)。结论 99mTc-奥曲肽眼眶SPECT/CT显像可以对TAO是否处于炎症活动期进行评估,使放射性核素显像的解剖定位更加精确,提高诊断效能。
Objective To investigate the clinical feasibility of orbital 99mTc-octreotide SPECT/CT in evaluating clinical activity of thyroid associated ophthalmopathy（TAO）.Methods Forty-one patients（82 eyes） with TAO underwent orbital 99mTc-octreotide SPECT/CT.Ten patients（20 eyes） of lung cancer without eye involvement（control group） underwent the same examination.Taking the clinical activity score（CAS） as standard,the uptake ratio（UR） of 99mTc-octreotide was calculated.Results All 82 eyes were divided into positive group（n=44） and negative group（n=38） according to result of imaging.The mean CAS of positive group and negative group was 3.60±0.99 and 0.97±1.19,respectively（P0.05）.The conformance between result of reading and CAS was medium.The mean UR of TAO patients was 1.54±0.50.The 82 eyes were divided into active stage group（CAS≥3,n=42） and inactive stage group（CAS3,n=40） according to CAS.The mean UR and mean CAS of active stage group was 1.80±0.49 and 3.81±0.99,while of inactive stage group was 1.23±0.32 and 0.74±0.89,respectively（all P0.05）.The correlation between UR and CAS was medium（r=0.61,P0.05）.The area under the curve of ROC was 0.803,threshold value of UR distinguished active stage and inactive stage was 1.38,the sensitivity and the specificity was 71.43% and 80.00%,respectively.The mean UR of the control group was 1.03±0.09,lower than that of TAO group（P0.05）.Conclusion UR may serve as a disease activity parameter.SPECT/CT can increase the diagnostic ability and anatomical location of 99mTc-octreotide in TAO.
出处
《中国医学影像技术》
CSCD
北大核心
2011年第3期505-509,共5页
Chinese Journal of Medical Imaging Technology
关键词
格雷夫斯眼病
锝
放射性核素显像
奥曲肽
Graves ophthalmopathy
Technetium
Radionuclide imaging
Octreotide
