右江医学2025，Vol.53Issue(7)：615-619,5.DOI:10.3969/j.issn.1003-1383.2025.07.006
SPECT/CT、超声分别联合血清甲状腺球蛋白诊断分化型甲状腺癌术后颈部淋巴结转移的价值
Value of SPECT/CT and ultrasonography combined with serum thyroglobulin in the diagnosis of postoperative cervical lymph node metastasis in differentiated thyroid carcinoma
摘要
Abstract
Objective To investigate and compare the diagnostic value of 131I-SPECT/CT imaging and ultrasound combined with serum thyroglobulin(Tg)in the diagnosis of cervical lymph node metastasis after differentiated thyroid carcinoma(DTC)surgery.Methods A total of 380 DTC patients who underwent surgery and 131I therapy in a hospital from August 2017 to December 2022 were retrospectively included.All cases were confirmed for cervical lymph node metastasis status by surgical pathology.Using pathological results as the gold standard,the sensitivity,specificity,accuracy,and other indices of SPECT/CT and ultrasonography—each combined with serum Tg—for detecting postoperative cervical lymph-node metastasis in DTC were analyzed.The diagnostic efficacy of different methods was compared by chi-square test.Results The diagnostic sensitivi-ty,specificity,and accuracy of cervical ultrasound combined with serum Tg were 90.0％(108/120),84.6％(220/260),and 86.3％(328/380),respectively.For SPECT/CT combined with serum Tg,the sensitivity was 93.3％(112/120),the speci-ficity was 92.3％(240/260),and the accuracy was 92.6％(352/380).Both combined diagnostic methods showed significant-ly better performance than single examinations in terms of sensitivity,specificity,and accuracy(all P＜0.05).Notably,SPECT/CT combined with serum Tg had a high consistency with pathological results(kappa=0.834,P＜0.001).Conclusion The diagnostic efficacy of SPECT/CT imaging combined with serum Tg after 131I therapy is significantly superior to that of ultrasound combined with Tg.It provides crucial guidance for the precise diagnosis of postoperative cervical lymph node metas-tasis in DTC and clinical decision-making,and merits further clinical promotion and application.关键词
分化型甲状腺癌/颈部淋巴结转移/甲状腺球蛋白/SPECT/CT显像/超声Key words
differentiated thyroid carcinoma(DTC)/cervical lymph node metastasis/thyroglobulin/SPECT/CT ima-ging/ultrasound分类
医药卫生引用本文复制引用
毛树怿,滚政荣,黄东菲,张玲丽,刘柳芳,刘观鑫..SPECT/CT、超声分别联合血清甲状腺球蛋白诊断分化型甲状腺癌术后颈部淋巴结转移的价值[J].右江医学,2025,53(7):615-619,5.基金项目
广西壮族自治区卫生健康委员会自筹经费科研课题(Z20211580,Z-B20220955,Z-B20240855) （Z20211580,Z-B20220955,Z-B20240855）
