CAJ | 학술논문

目的：评价治疗剂量的131 I-SPECT/CT断层融合显像检测血清甲状腺球蛋白升高（Tg＋）而诊断剂量131 I全身显像阴性（Dx-WBS-）的分化型甲状腺癌（DTC）转移灶的价值。方法回顾性分析49例血清Tg＋DxWBS-的DTC患者（滤泡状2例，乳头状47例），给予盲法大剂量131 I（7400MBq）治疗后第7天行131 I-全身显像（Rx-WBS）和头颈部、胸部131 I-SPECT/CT断层融合显像，在病灶水平分析131 I-SPECT/CT断层融合图像对 DTC 定位和定性诊断情况。结果治疗剂量131 I 全身显像显示阳性病例16例（32．7％），其中甲状腺残留1例，转移灶15例（30．6％）。经过131 I-SPECT/CT断层融合显像均检测出上述转移灶，同时新发现6例患者的转移灶，转移灶检出率42．9％。结论 Rx-WBS可检测出部分Tg＋DxWBS-的DTC患者的转移灶；对Tg＋DxWBS-的DTC患者常规行头颈部、胸部131 I-SPECT/CT断层融合图像可提高Tg＋DxWBS-的DTC患者的转移灶的诊断准确率。
목적：평개치료제량적131 I-SPECT/CT단층융합현상검측혈청갑상선구단백승고（Tg＋）이진단제량131 I전신현상음성（Dx-WBS-）적분화형갑상선암（DTC）전이조적개치。방법회고성분석49례혈청Tg＋DxWBS-적DTC환자（려포상2례，유두상47례），급여맹법대제량131 I（7400MBq）치료후제7천행131 I-전신현상（Rx-WBS）화두경부、흉부131 I-SPECT/CT단층융합현상，재병조수평분석131 I-SPECT/CT단층융합도상대 DTC 정위화정성진단정황。결과치료제량131 I 전신현상현시양성병례16례（32．7％），기중갑상선잔류1례，전이조15례（30．6％）。경과131 I-SPECT/CT단층융합현상균검측출상술전이조，동시신발현6례환자적전이조，전이조검출솔42．9％。결론 Rx-WBS가검측출부분Tg＋DxWBS-적DTC환자적전이조；대Tg＋DxWBS-적DTC환자상규행두경부、흉부131 I-SPECT/CT단층융합도상가제고Tg＋DxWBS-적DTC환자적전이조적진단준학솔。
Objective To compare 131 I whole body scan(Rx-WBS)and SPECT/CT imaging after131 I therapy for detecting metastatic lesions from differentiated thyroid carcinoma in patients with thyroglobulin elevation but negative iodine scintigraphy.Methods This study re-viewed 49 patients with thyroglobulin elevation but negative iodine scintigraphy from differentiated thyroid carcinoma[1 1 men and 39 women, 2 follicular and 47 papillary thyroid cancer,age 12~73(46 ±17)years]who underwent Rx-WBS and SPECT/CT imaging after 131 I therapy (7 days after administration).The dosage of 131 I were 7400MBq.Investigated the utility of post-therapeutic SPECT/CT imaging for detecting metastatic lesions.Results In the visual analysis,Rx-WBS show the lesions of 16 patients(32.7%):Thyroid remnants in 1 patient,distant metastasis in 15 patients(30.6%),Including the lymph node metastases in 1 1 patients (3 cases for multiple lesions),lung metastasis in 1 patient,and bone metastasis in 1 patient,2 cases of suspicious lesions.Through 131 I-SPECT/CT fusion image,All of the above Positive lesions were detected;6 cases with metastatic lesions were new found(42% detection rate of metastases).Conclusions Rx-WBS can increase the detection of metastases in patient with DTC with thyroglobulin elevation but negative iodine scintigraphy.Delayed post-therapeutic SPECT/CT fusion imaging showed a higher detection rate than Rx-WBS.