摘要
目的用ROC曲线法分析99mTc-MIBI显像对鉴别甲状腺结节良恶性的诊断效能。方法选择甲状腺99mTcO4-显像"冷"或"凉"结节患者59例共75个结节行99mTc-MIBI显像,其中确诊良性结节58个(良性组),恶性结节17个(恶性组),对结果进行半定量和ROC曲线法分析,并对两种方法进行比较。结果恶性组和良性组5min时靶/非靶(T/N)比值分别为1.63±1.09、0.86±0.36,1h分别为1.59±1.05、0.88±0.29,恶性组T/N比值均显著高于良性组。半定量法显示5min时诊断灵敏度47.06%(8/17)、特异度93.10%(54/58),准确率82.67%(62/75);1h时诊断灵敏度52.94%(9/17)、特异度94.83%(55/58),准确率85.33%(64/75)。ROC法曲线下面积5min、1h时均为0.86,以5min时0.99为界值,诊断灵敏度88.24%、特异度75.86%、准确率78.67%。以1h时0.93为界值,诊断灵敏度88.24%、特异性79.31%、准确率81.33%。两种界值灵敏度、特异度比较差异有统计学意义。结论 99mTc-MIBI显像对鉴别甲状腺肿瘤良恶性有诊断价值;采用ROC曲线分析法可提高99mTc-MIBI显像对鉴别甲状腺"冷"、"凉"结节良恶性的诊断效能。
Objective To assess the efficiency of 99mTc-MIBI imaging for differential diagnosis of benign and malignant thyroid nodules using receiver operating characteristic（ROC） curve analysis.Methods Fifty-nine patients with 75 lesions which 99mTcO-4 imaging showed cold or cool nodules were selected for further 99mTc-MIBI imaging.There were 58 benign nodules（benign group） and 17 malignant nodules（malignant group） confirmed pathologically.The results of analysis by semi-quantitative and ROC curve were compared.Results The thyroid to normal tissue（T/N） ratios on 5 min were 1.63±1.09 and 0.86±0.36,on 1 h were 1.59±1.05 and 0.88±0.29 in malignant and benign group,respectively.The ratios of malignant group were significantly higher than those of benign group.The sensitivity,specificity and accuracy rate of semi-quantitative analysis was 47.06%（8/17）,93.10%（54/58） and 82.67%（62/75） on 5 min,while was 52.94%（9/17）,94.83%（55/58） and 85.33%（64/75） on 1 h.With threshold T/N=0.99 on 5 min from ROC curves,the diagnostic sensitivity,specificity and accuracy rate was 88.24%,75.86% and 78.67%,respectively,while with threshold T/N=0.93 on 1 h from ROC curves,the diagnostic sensitivity,specificity and accuracy rate was 88.24%,79.31% and 81.33%,respectively.The areas under ROC curve were both 0.86 at 5 min and 1 h.The sensitivity and specificity were significantly different between the two thresholds.Conclusion Thyroid 99mTc-MIBI imaging has diagnostic efficiency in differentiating benign and malignant thyroid nodules.The diagnostic capability of 99mTc-MIBI imaging in differentiating benign and malignant of cold or cool nodules can be improved by using ROC curve analysis.
出处
《中国介入影像与治疗学》
CSCD
2011年第6期514-517,共4页
Chinese Journal of Interventional Imaging and Therapy
