Leung Hung-Cheung, Chang Chwen-Tzuei, Wu Hurng-Sheng, Wang Tzu-Yuan, Sun Shung-Shung, Kao Chia-Hung
Division of General Surgery, Department of Surgery, Show Chwan Memorial Hospital, Changhua, Taiwan.
Endocr Res. 2003 Aug;29(3):291-7. doi: 10.1081/erc-120025036.
It remains difficult to pre-operatively differentiate follicular carcinoma and adenoma even under intraoperative investigations including histopathologic diagnosis of frozen sections.
We retrospectively compared dual phase thallium (Tl-201) thyroid scan and fine-needle aspiration (FNA) cytology to detect follicular carcinoma in 12 patients with cold thyroid nodules. Fine-needle aspiration cytology results were assessed and categorized by experienced pathologists into benign, suspicious, and malignant. Dual phase Tl-201 thyroid scan including an early (10-min) image and a delayed (3-hour) image were acquired after 2 mCi (74 MBq) of Tl-201 was injected intravenously. Dual phase Tl-201 thyroid scan findings were visually interpreted as positive and negative results.
Based on FNA cytologic interpretation criteria, three nodules were diagnosed as benign, five nodules were diagnosed as suspicious, and four nodules were diagnosed as malignant. However, based on dual phase Tl-201 thyroid scan interpretation criteria, all of the 12 nodules could accurately diagnose as malignant.
We conclude that dual phase Tl-201 thyroid scan was more accurate in diagnosing follicular carcinoma when comparing with FNA cytology.
即使在包括冰冻切片组织病理学诊断在内的术中检查下，术前区分滤泡状癌和腺瘤仍然很困难。
我们回顾性比较了双期铊（Tl - 201）甲状腺扫描和细针穿刺（FNA）细胞学检查，以检测12例甲状腺冷结节患者中的滤泡状癌。由经验丰富的病理学家对细针穿刺细胞学检查结果进行评估并分类为良性、可疑和恶性。在静脉注射2毫居里（74兆贝可）的Tl - 201后，获取包括早期（10分钟）图像和延迟（3小时）图像的双期Tl - 201甲状腺扫描。双期Tl - 201甲状腺扫描结果通过视觉解读为阳性和阴性结果。
根据FNA细胞学解读标准，3个结节被诊断为良性，5个结节被诊断为可疑，4个结节被诊断为恶性。然而，根据双期Tl - 201甲状腺扫描解读标准，12个结节均能准确诊断为恶性。
我们得出结论，与FNA细胞学相比，双期Tl - 201甲状腺扫描在诊断滤泡状癌方面更准确。
