Lai Xing-jian, Zhang Bo, Jiang Yu-xin, Dai Qing, Zhao Rui-na
Department of Ultrasound, PUMC Hospital, Beijing, China.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2013 Aug;35(4):393-7. doi: 10.3881/j.issn.1000-503X.2013.04.007.
To evaluate the diagnostic values of ultrasound (US) and (18)F-fluoro-2-deoxy-D-glucose-positron emission tomography (FDG PET)/computerized tomography (CT) in diagnosing suspected thyroid carcinoma and lymph node metastasis.
The clinical data of 28 patients who had undergone total or subtotal thyroidectomy with or without neck dissection from December 2011 to December 2012 in PUMC Hospital and had undergone US and FDG PET/CT before surgery were retrospectively analyzed. In each patient, US and FDG PET/CT images were retrospectively reviewed to determine the presence of carcinoma with or without loco-regional metastasis by level-by-level analysis. The potential correlation between imaging results and histopathology were analyzed.
There were 11 benign lesions,15 papillary carcinomas, one follicular carcinoma, and one medullary carcinoma. For thyroid carcinoma,the sensitivity and specificity were 88.2% and 63.6% for US and 76.5% and 54.5% for FDG PET/CT(P>0.05). For lymph node metastasis, the sensitivity was 68.0% for US and 60.0% for FDG PET/CT (P>0.05), and the specificity was 96.7% for US and FDG PET/CT.FDG PET/CT could provide more diagnostic information than US for patients with level 2 or 5 metastasis.
Combination of US and FDG PET/CT is typically not needed for differentiating thyroid lesions.However, for patients with suspected lymph node metastasis of infrequently involved levels, the combination of US and FDG PET/CT may be a good choice.
评估超声(US)及18F-氟-2-脱氧-D-葡萄糖-正电子发射断层扫描(FDG PET)/计算机断层扫描(CT)在诊断疑似甲状腺癌及淋巴结转移中的价值。
回顾性分析2011年12月至2012年12月在协和医院接受甲状腺全切或次全切除术(伴或不伴颈部淋巴结清扫)且术前接受过US及FDG PET/CT检查的28例患者的临床资料。对每位患者的US及FDG PET/CT图像进行回顾性分析,通过逐层分析确定有无癌及有无局部区域转移。分析影像学结果与组织病理学之间的潜在相关性。
有11例良性病变、15例乳头状癌、1例滤泡状癌和1例髓样癌。对于甲状腺癌,US的敏感度和特异度分别为88.2%和63.6%,FDG PET/CT的敏感度和特异度分别为76.5%和54.5%(P>0.05)。对于淋巴结转移,US的敏感度为68.0%,FDG PET/CT的敏感度为60.0%(P>0.05),US和FDG PET/CT的特异度均为96.7%。对于2区或5区转移的患者,FDG PET/CT比US能提供更多诊断信息。
鉴别甲状腺病变通常无需联合使用US和FDG PET/CT。然而,对于疑似罕见受累区域淋巴结转移的患者,联合使用US和FDG PET/CT可能是个不错的选择。