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

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【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 中图分类号：R736.1 文献标志码：A DOI： 10.3969/j .issn.1003-1383.2025.07.006

【Abstract】 Objective To investigate and compare the diagnostic value of 131 I-SPECT/CT imaging and ultrasound combined withserumthyroglobulin（Tg）inthediagnosisofcervicallymphnodemetastasisafterdiferentiatedthyroidcarcinoma（DTC） surgery.MethodsA total of 38O DTC patients who underwent surgery and 131I therapy in a hospital from August 2017 to December 2022 were retrospectivelyincluded.Allcases wereconfirmed forcervical lymph node metastasis status bysurgical pathology.Using pathologicalresultsasthegoldstandard，thesensitivity，specificity，acuracy，andotherindicesofSPEC/ CTandultrasonography—eachcombined withserum Tg—fordetecting postoperativecervical lymph-nodemetastasis inDTC wereanalyzed.Thediagnosticeficacyof diferentmethodswascomparedbychi-squaretest.ResultsThediagnosticsensitivity，specificity，and accuracy of cervical ultrasound combined with serum Tg were 90.0% （108/120）， 84.6% （220/260），and （2号 86.3% （328/380），respectively.For SPECT/CTcombined with serum Tg，the sensitivity was 93.3%（112/12O），the specificity was 92.3% （240/260），and the accuracy was 92.6% （352/380）. Both combined diagnostic methods showed significantly 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 ultrasoundcombied withTg.Itprovides crucial guidancefortheprecisediagnosisof postoperativecervical lymph node metastasis in DTC and clinical decision-making，and merits further clinical promotion and application.

【Keywords】diferentiated thyroid carcinoma（DTC）；cervical lymph node metastasis；thyroglobulin；SPECT/CT imaging；ultrasound

甲状腺癌是头颈部常见的恶性肿瘤，其中分化型甲状腺癌（differentiated thyroid carcinoma，DTC）是最主要的病理类型，约占所有甲状腺癌病例的90%[1] 。（剩余6416字）