摘要
目的：探讨锝标记的生长抑素类似物奥曲肽（99mTc-OCT）单光子发射计算机断层显像（SPECT）在甲状腺相关性眼病（TAO）诊断评价中的价值与应用。方法：选择核医学科门诊因甲状腺疾病就诊以眼部不适为主诉（流泪、畏光、眼痛、视力改变、眼睑挛缩、突眼等）的患者19例，共38只眼睛，以EUGOGO推荐的诊断标准将就诊患者共38只眼睛分为TAO组（30只）、非TAO组（8只）。其中TAO组按疾病活动度分为活动组（24只）、非活动组（6只）；按严重度分为轻度组（11只）、中~重度组（19只）。另招募健康志愿者5例，作为健康对照组（10只）。对所有患者及健康志愿者均行头部99mTc-OCT SPECT显像，对结果进行半定量分析，计算受检者眼部最高放射性计数与枕部头皮最低放射性计数比值（T/B）作为每只眼睛的99mTc-OCT摄取值，并行ROC曲线法分析。结果：非TAO组与健康对照组T/B有显著性差异（t＝2.76，P=0.014）；TAO组与健康对照组T/B有极显著性差异（t＝5.86，P＜0.001）。TAO组和非TAO组T/B亦有极显著性差异（t＝2.78，P=0.009），且TAO活动组和非活动组T/B有显著性差异（t＝2.59，P=0.015）。ROC法曲线下面积TAO组和非TAO组为0.821、活动组和非活动组为0.854，获得最适界点的T/B比值分别为1.637及1.674；以此为界值，确诊TAO的灵敏度为83.3％、特异度87.5％、准确率84.2％；鉴别TAO活动期的灵敏度为87.5％、特异性83.3％、准确率86.7％。结论：99mTc-OCT SPECT显像结合半定量分析能较准确地确诊TAO及鉴别TAO活动期，有益于指导TAO个体化治疗方案的制定。
Abstract
Objective: To investigate the value of 99mTc-OCT SPECT imaging in the diagnosis of thyroid associated ophthalmopathy(TAO). Methods: Nineteen outpatients(38 eyes) in Nuclear Medicine Department whose main complaint is discomfort around the eye area(tearing, photophobia, eye pain, changes in vision, eyelid contracture and exophthalmos) underwent orbital 99mTc-OCT SPECT． Five healthy volunteers(10 eyes) recruited(healthy control group) underwent the same examination. Taking the EUGOGO clinical diagnostic criteria, all outpatients’ eyes were divided into TAO group(30) and non-TAO group(8). According to its clinical activity score(CAS), the TAO group was divided into active group(24) and inactive group(6); and at the same time, the TAO group was divided into mild group(11) and moderate-severe group(19) by the disease severity. Then the ratios of the highest eye radioactive count(T) to the lowest occipital scalp radioactive count(B) in all eyes were calculated, as the eye 99mTc-OCT intake. Receiver operating characteristic(ROC) analysis was employed to define the threshold value of T/B ratio. Results: There is a significant difference in T/B ratio between non-TAO group and healthy control group(t＝2.76, P=0.014), and a highly significant difference between TAO group and healthy control group(t＝5.86, P＜0.001). The significant difference in T/B ratios were still found between TAO group and non-TAO(t=2.78, P=0.009), while a highly significant difference also found between active group and inactive group(t=2.59, P=0.015)． The area under the curve of ROC for TAO group and non-TAO group was 0.821, and 0.854 for active group and inactive group; the threshold value of T/B ratio was 1.637 for identifying TAO, and its sensitivity, specificity and accuracy were 83.3%, 87.5% and 84.2%; the threshold value of T/B ratio for distinguishing between active group and inactive group was 1.674, and its sensitivity, specificity and accuracy was 87.5%, 83.3% and 86.7%, respectively． Conclusion: 99mTc-OCT SPECT imaging combined with semi-quantitative analysis can give more accurate diagnosis in identifying TAO and distinguishing active TAO, and it is helpful to guide the individualized treatment plan for TAO.
关键词
格雷夫斯病 /
放射性核素显像
Key words
Grave’s disease /
Radionuclide imaging
田金玲;陈 飞;韩云峰;董庆建;赵 明;陈 璟.
放射受体显像在甲状腺相关性眼病诊断中的价值[J]. 中国临床医学影像杂志. 2013, 24(9): 613-616
TIAN Jin-ling;CHEN Fei;HAN Yun-feng;DONG Qing-jian;ZHAO Ming;CHEN Jing.
The value of the radioreceptor imaging in the diagnosis of thyroid associated ophthalmopathy[J]. Journal of China Clinic Medical Imaging. 2013, 24(9): 613-616
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
