摘要
目的:探讨131I全身显像(131I-WBS)与131I单光子发射型计算机断层显像/计算机体层摄影术(131I-SPECT/CT)同机融合显像对于分化型甲状腺癌(DTC)术后131I治疗患者的诊治价值。方法:选择术后经病理证实并接受131I治疗的DTC 48例,3~5 d后同期行131I-WBS和131I-SPECT/CT断层融合显像。将131I-WBS与131I-SPECT/CT断层融合图像进行对比分析,探讨各自显像特点与临床价值。结果:48例DTC患者共行131I-WBS 48次,131I-SPECT/CT断层融合显像60次。在131I-WBS发现的总计145处摄碘灶中,甲状腺床占34.3%,恶性病灶占60.5%,非甲状腺生理性和良性病变摄取以及污染占5.2%。131I-SPECT/CT融合显像比131I-WBS多发现23处转移灶。在131I-WBS无法确诊的20例65处摄碘灶中,通过131I-SPECT/CT断层融合显像获得准确定位和定性诊断的分别占100%和94%。共使18例(37.5%,18/48)患者获得了更多的增益价值,且其中8例(44.4%,8/18)患者治疗方案发生了改变。结论:131I-WBS应常规应用于DTC术后131I治疗患者。当131I-WBS诊断不明确或者与临床表现不符时,加做131I-SPECT/CT断层融合显像在提高DTC诊断正确率、制定和调整治疗方案上具有重要临床价值。
Objective：To explore the clinical values of 131I whole-body scan （131I-WBS） and 131I single photon emission computed tomography/computed tomography （131I-SPECT/CT） on the management of patients with differentiated thyroid carcinoma （DTC） after 131I therapy,respectively. Methods：After 3~5 days 131I therapy,48 DTC patients underwent 131I-WBS and 131I-SPECT/CT. The imaging features and clinical values of 131I-WBS and 131I-SPECT/CT were comparatively analyzed. Results：The patients had totally 48 131I-WBS and 60 131I-SPECT/CT. 145 foci were observed by 131I-WBS,including 34.3% of foci localized in the thyroid bed,60.5% of malignant lesions,and 5.2% caused by nonthyroid physiologic or benign uptake or a contaminant. There were 23 additional metastases detected by 131I-SPECT/CT. Futhermore,there were 20 patients whose 131I-WBS showed 65 inconclusive lesions. Precise localization and characterization by 131I-SPECT/CT fusion images were 65（100 %） and 61（94 %） of the 65 foci,respectively. 131I-SPECT/CT fusion images were considered to be of much benefit to 18（37.5%） of 48 patients. Changes of therapeutic plans happened to 8（44.4%） of 18 patients. Conclusion：131I-WBS should be routinely performed in the management of patients with DTC after 131I therapy. If 131I-WBS images were inconclusive or inconsistent with the clinical manifestations,131I-SPECT/CT must be required to increase the diagnostic accuracy and modulate therapeutic plans.
出处
《南京医科大学学报（自然科学版）》
CAS
CSCD
北大核心
2013年第11期1608-1612,共5页
Journal of Nanjing Medical University(Natural Sciences)
