CAJ | 학술논문

目的评估MRI检查对Graves病(Graves disease，GD)患者131I核素治疗效果的早期评价能力。材料与方法18例GD患者于131I治疗前、治疗后1个月和3个月分别进行MRI检查，按治疗后3个月甲状腺功能指标分为有效组(n=9)例和无效组(n=9)。盲法测量并比较GD患者131I治疗前后甲状腺总体积和甲状腺平均表观扩散系数(ADC)值的变化。结果 GD患者治疗后1个月与治疗前比较，有效组甲状腺体积减小(P<0.01)，无效组变化不显著(P=0.07)，有效组和无效组甲状腺平均ADC值均无变化(P值分别为0.54、0.27)。有效组治疗后3个月与治疗前比较，甲状腺体积明显减小(P<0.01)，无效组亦减小(P<0.05)，平均ADC值有效组减小(P<0.05)，无效组无变化(P=0.46)。治疗后3个月和治疗后1个月比较，有效组甲状腺体积减小(P<0.05)，无效组变化不显著(P=0.20)，有效组和无效组甲状腺平均ADC值均无变化(P值分别为0.53、0.08)。结论甲状腺体积和平均ADC值变化可早期反映GD核素治疗效果。
목적평고MRI검사대Graves병(Graves disease，GD)환자131I핵소치료효과적조기평개능력。재료여방법18례GD환자우131I치료전、치료후1개월화3개월분별진행MRI검사，안치료후3개월갑상선공능지표분위유효조(n=9)례화무효조(n=9)。맹법측량병비교GD환자131I치료전후갑상선총체적화갑상선평균표관확산계수(ADC)치적변화。결과 GD환자치료후1개월여치료전비교，유효조갑상선체적감소(P<0.01)，무효조변화불현저(P=0.07)，유효조화무효조갑상선평균ADC치균무변화(P치분별위0.54、0.27)。유효조치료후3개월여치료전비교，갑상선체적명현감소(P<0.01)，무효조역감소(P<0.05)，평균ADC치유효조감소(P<0.05)，무효조무변화(P=0.46)。치료후3개월화치료후1개월비교，유효조갑상선체적감소(P<0.05)，무효조변화불현저(P=0.20)，유효조화무효조갑상선평균ADC치균무변화(P치분별위0.53、0.08)。결론갑상선체적화평균ADC치변화가조기반영GD핵소치료효과。
Objective:To evaluate the early effect of 131I nuclide therapy in Graves’ disease by MRI. Materials and Methods: MRI was performed in 18 GD patients before and at 1, 3 months after 131I nuclide therapy respectively. According to the follow-up thyroid function laboratory results at 3 months, the enrolled GD patients were divided into effective group (n=9) and ineffective group (n=9). Overall thyroid volume and apparent diffusion coefifcient (ADC) values were measured blindly and the changes of volumes and ADCs were compared longitudinally in both groups. Results:Compared with GD patients before 131I nuclide therapy, the thyroid volume decreased significantly in effective group (P<0.01) in the patients one month after therapy, while there was no change in ineffective group (P=0.07), and there was no change for the average thyroid ADC values in both groups (P=0.54, 0.27). The thyroid volume decreased signiifcantly in both effective group (P<0.01) and ineffective group (P<0.05) in GD patients three months after therapy compared with patients before therapy;the average thyroid ADC values decreased in effective group (P<0.05), however, there was no change in ineffective group (P=0.46). The thyroid volume decreased signiifcantly in effective group (P<0.05) but there was no change in ineffective group (P=0.20) three months after therapy compared with that of one month after therapy, and there was no change for the average thyroid ADC values in both groups (P=0.53, 0.08) between three and one months after therapy. Conclusion:The overall thyroid volume and the average ADC values could demonstrate early response after 131I nuclide therapy in Graves’ disease patients.