CAJ | 학술논문

目的探讨分化型甲状腺癌(DTC)术后131I治疗患者胸腺生理性摄取131I的临床特点及131I全身显像(WBS)的影像学特征.方法收集2007年至2013年收治的1882例次DTC术后131I治疗后第3～5天行WBS的患者,分析WBS上纵隔部位有131I摄取,并根据甲状腺球蛋白、甲状腺球蛋白抗体测定、其他影像学检查及临床随访结果最终被证实为胸腺生理性摄取131I的患者资料.结果胸腺生理性摄取131I者共16例,年龄均＜45岁,其中有15例患者至少接受过2次131I治疗,仅有1例第1次131I治疗后胸腺显影;WBS上胸腺生理性摄取131I主要表现为“弥漫性”或“哑铃状”浓聚灶;且胸腺对131I的生理性摄取随重复131I治疗次数的增加而越来越明显.结论胸腺生理性摄取131I是45岁以下DTC术后患者多次131I治疗后WBS假阳性的重要原因之一,充分认识到这一现象并予以鉴别,对于患者下一步的恰当诊治是十分必要的.
목적 탐토분화형갑상선암(DTC)술후131I치료환자흉선생이성섭취131I적림상특점급131I전신현상(WBS)적영상학특정.방법 수집2007년지2013년수치적1882례차DTC술후131I치료후제3～5천행WBS적환자,분석WBS상종격부위유131I섭취,병근거갑상선구단백、갑상선구단백항체측정、기타영상학검사급림상수방결과최종피증실위흉선생이성섭취131I적환자자료.결과 흉선생이성섭취131I자공16례,년령균＜45세,기중유15례환자지소접수과2차131I치료,부유1례제1차131I치료후흉선현영;WBS상흉선생이성섭취131I주요표현위“미만성”혹“아령상”농취조;차흉선대131I적생이성섭취수중복131I치료차수적증가이월래월명현.결론 흉선생이성섭취131I시45세이하DTC술후환자다차131I치료후WBS가양성적중요원인지일,충분인식도저일현상병여이감별,대우환자하일보적흡당진치시십분필요적.
Objective To explore the clinical features and 131I whole body scans (WBS) characteristics of physiological thymic uptake of 131I in post-operative patients with differentiated thyroid cancer (DTC).Methods One thousand eight hundred and eighty-two WBS were performed on the 3-5 day after 1nI therapy in post-operative patients with DTC between 2007 and 2013.On the basis of thyroglobulin and thyroglobulin antibody measurement,other imaging and clinical follow-up,the mediastinal activity was attributed to physiological thymic uptake of 131I.For such patients,their data were reviewed retrospectively.Results Physiological thymic uptake of 131I were confirmed in 16 patients.All of them were under the age of 45.Fifteen patients received at least two therapeutic doses of 131I,and there was only one patient to be found physiological thymic uptake of 131I on the first treatment.The pattem of physiological thymic uptake of 131I was classified as "diffuse" or "dumbbell".Thymic uptake of 131I became more prominent with repeated treatments.Conclusions For the next appropriate treatment,it is essential to acknowledge that physiological thymic uptake of 131I in patients with DTC under the age of 45 is an important cause of false-positive WBS.