CAJ | 학술논문

目的：肺部是分化型甲状腺癌（differentiated thyroid carcinoma，DTC）的常见转移部位，131I治疗是DTC术后患者肺转移的主要治疗方法，其治疗后常规行131I-全身扫描（whole body scan，WBS），本文主要研究DTC肺转移患者WBS显像中肺部病灶显像的影响因素。方法：回顾性分析在天津医科大学肿瘤医院分子影像与核素诊疗科行131I治疗的DTC肺转移患者60例，治疗前均行甲状腺功能检测、颈胸部CT检查，治疗后行WBS显像。根据WBS肺部转移灶显像情况将患者分为显像阳性组和显像阴性组，分析相关影响因素。结果：单因素分析提示，患者的年龄、肺部纤维条索影、钙化影、斑片影等与WBS肺部显像情况相关。双变量Logistic回归分析提示肺部纤维条索影（OR=0.175，P<0.001）及钙化影（OR=0.088，P<0.05）不利于WBS肺部转移灶的显像。结论：年龄较大患者的WBS肺部病灶显像效果不佳，肺部存在条索影、钙化影、斑片影等不利于WBS肺部转移灶的显像，肺部条索及钙化是影响WBS肺转移灶显像的主要因素。
목적：폐부시분화형갑상선암（differentiated thyroid carcinoma，DTC）적상견전이부위，131I치료시DTC술후환자폐전이적주요치료방법，기치료후상규행131I-전신소묘（whole body scan，WBS），본문주요연구DTC폐전이환자WBS현상중폐부병조현상적영향인소。방법：회고성분석재천진의과대학종류의원분자영상여핵소진료과행131I치료적DTC폐전이환자60례，치료전균행갑상선공능검측、경흉부CT검사，치료후행WBS현상。근거WBS폐부전이조현상정황장환자분위현상양성조화현상음성조，분석상관영향인소。결과：단인소분석제시，환자적년령、폐부섬유조색영、개화영、반편영등여WBS폐부현상정황상관。쌍변량Logistic회귀분석제시폐부섬유조색영（OR=0.175，P<0.001）급개화영（OR=0.088，P<0.05）불리우WBS폐부전이조적현상。결론：년령교대환자적WBS폐부병조현상효과불가，폐부존재조색영、개화영、반편영등불리우WBS폐부전이조적현상，폐부조색급개화시영향WBS폐전이조현상적주요인소。
Objective: Lung metastases are common in patients with differentiated thyroid carcinoma (DTC). Post-therapeutic 131I-whole-body scan (WBS) was conventionally administered after the radioactive iodine treatment (RAI) of DTC lung metastases. This study aimed to investigate the influencing factors of WBS imaging on the RAI of DTC lung metastases. Methods:DTC patients (n=60) with lung metastases treated with 131I were retrospectively included. Before treatment, the thyroid function was assessed. Neck and chest computed tomography (CT) was performed, and WBS was inspected. Patients with lung metastases were classified into negative and positive subgroups according to the imaging of 131I WBS, and the relative influencing factors were analyzed. Results:Univariate analy-sis showed that age and chest CT imaging, which revealed pulmonary fibrosis, calcification, and patchy shadows, were related to WBS imaging. Binary variable logistic regression analysis revealed that pulmonary fibrosis (OR=0.175, P<0.001) and calcification (OR=0.088, P<0.05) went against the development of WBS. Conclusion:WBS imaging on RAI of lung metastases was not obvious in the el-derly. The fibrosis, calcification, and patchy shadows of the lung were not conducive for WBS imaging. The fibrosis and calcification of the lung were the main factors that affect WBS imaging.