中国医学影像学杂志
中國醫學影像學雜誌
중국의학영상학잡지
CHINESE JOURNAL OF MEDICAL IMAGING
2012年
10期
782-785
,共4页
甲状腺肿瘤%体层摄影术,发射型计算机,单光子%碘放射性同位素
甲狀腺腫瘤%體層攝影術,髮射型計算機,單光子%碘放射性同位素
갑상선종류%체층섭영술,발사형계산궤,단광자%전방사성동위소
Thyroid neoplasms%Tomography, emission-computed, single-photon%Iodine radioisotopes
目的评价分化型甲状腺癌(DTC)治疗剂量的131I-SPECT/CT 融合显像对131I 全身扫描(WBS)的增益价值.资料与方法57例复发或转移的DTC 患者131I 治疗后行 WBS 及131I-SPECT/CT 显像,最终诊断以病理、影像检查和临床随访结果为依据.对比两种检查结果,在病灶和患者两种水平上评价SPECT/CT 显像 DTC 定位和定性诊断的增益价值,及其对治疗策略的影响.结果57例 WBS 共发现215处放射性摄取病灶,经 SPECT/CT 融合显像均准确定位,并排除了12例假阳性病灶.融合显像还新发现37处摄碘病灶和45处不摄碘病灶.WBS 和 SPECT/CT 融合显像诊断 DTC 摄碘转移灶的敏感性分别为80.1%、100.0%;特异性为63.6%、81.8%;准确性为78.1%、97.8%.融合显像对摄碘转移灶的总体检出率较高(χ2=8.50, P<0.05),对摄碘转移灶的诊断价值增加了24.5%(66/269),15例(26.3%)患者的治疗策略获得了改进.结论131I-SPECT/CT 融合显像能更好地对放射性摄取增高灶进行精确定位和定性,对 WBS 诊断不明确的 DTC 加做 SPECT/CT 显像在提高诊断准确率、减少伪影和调整治疗方案上具有重要价值.
目的評價分化型甲狀腺癌(DTC)治療劑量的131I-SPECT/CT 融閤顯像對131I 全身掃描(WBS)的增益價值.資料與方法57例複髮或轉移的DTC 患者131I 治療後行 WBS 及131I-SPECT/CT 顯像,最終診斷以病理、影像檢查和臨床隨訪結果為依據.對比兩種檢查結果,在病竈和患者兩種水平上評價SPECT/CT 顯像 DTC 定位和定性診斷的增益價值,及其對治療策略的影響.結果57例 WBS 共髮現215處放射性攝取病竈,經 SPECT/CT 融閤顯像均準確定位,併排除瞭12例假暘性病竈.融閤顯像還新髮現37處攝碘病竈和45處不攝碘病竈.WBS 和 SPECT/CT 融閤顯像診斷 DTC 攝碘轉移竈的敏感性分彆為80.1%、100.0%;特異性為63.6%、81.8%;準確性為78.1%、97.8%.融閤顯像對攝碘轉移竈的總體檢齣率較高(χ2=8.50, P<0.05),對攝碘轉移竈的診斷價值增加瞭24.5%(66/269),15例(26.3%)患者的治療策略穫得瞭改進.結論131I-SPECT/CT 融閤顯像能更好地對放射性攝取增高竈進行精確定位和定性,對 WBS 診斷不明確的 DTC 加做 SPECT/CT 顯像在提高診斷準確率、減少偽影和調整治療方案上具有重要價值.
목적평개분화형갑상선암(DTC)치료제량적131I-SPECT/CT 융합현상대131I 전신소묘(WBS)적증익개치.자료여방법57례복발혹전이적DTC 환자131I 치료후행 WBS 급131I-SPECT/CT 현상,최종진단이병리、영상검사화림상수방결과위의거.대비량충검사결과,재병조화환자량충수평상평개SPECT/CT 현상 DTC 정위화정성진단적증익개치,급기대치료책략적영향.결과57례 WBS 공발현215처방사성섭취병조,경 SPECT/CT 융합현상균준학정위,병배제료12례가양성병조.융합현상환신발현37처섭전병조화45처불섭전병조.WBS 화 SPECT/CT 융합현상진단 DTC 섭전전이조적민감성분별위80.1%、100.0%;특이성위63.6%、81.8%;준학성위78.1%、97.8%.융합현상대섭전전이조적총체검출솔교고(χ2=8.50, P<0.05),대섭전전이조적진단개치증가료24.5%(66/269),15례(26.3%)환자적치료책략획득료개진.결론131I-SPECT/CT 융합현상능경호지대방사성섭취증고조진행정학정위화정성,대 WBS 진단불명학적 DTC 가주 SPECT/CT 현상재제고진단준학솔、감소위영화조정치료방안상구유중요개치.
Purpose To evaluate the added value of therapeutic dose 131I SPECT/CT to planar 131I whole body scan(WBS) in the management of patients with differentiated thyroid cancer (DTC). Materials and Methods 57 pathology proven DTC patients with relapse or metastasis were examined with post-therapeutic planar 131I imaging and SPECT/CT. The added value of SPECT/CT was determined on levels of individual focus and each patient, and the change of management was analyzed. Results 215 foci shown on planar 131I imaging were accurately localized by SPECT/CT, and 12 false positive lesions were excluded. Additional 37 foci of increased uptake and 45 foci without uptake were detected by 131I SPECT/CT. WBS and 131I SPECT/CT showed sensitivity of 80.1% and 100.0%, specificity of 63.6%and 81.8%, accuracy of 78.1% and 97.8%, respectively. 131I SPECT/CT was more accurate in detecting metastatic focus than WBS (χ2=8.50, P<0.05). In 24.5% of 269 (n=66) iodine-avid foci, additional information was provided on 131I SPECT/CT, of which 15 (26.3%) had management modification based on this information. Conclusion Compared with planar whole body imaging, 131I SPECT/CT correctly decides disease classification and location, and it is important to receive SPECT/CT for uncertain DTC by WBS to improve diagnosis, reduce artifact and adjust therapeutic regimen.
