摘要
目的:评价诊断剂量(5 mCi)的131I-SPECT/CT断层融合显像在分化型甲状腺癌(differentiated thyroid carcinoma,DTC)首次去除治疗后准确分期的价值。方法:56例经过首次去除治疗后6+月或12+月的DTC患者,其中男性16例,女性40例,平均年龄35岁,分别行诊断性131I-全身显像(131I-WBI)和头颈部、胸部131I-SPECT/CT断层融合显像,结果分别由两名教授读片(其中一位不知道病情),在病灶水平分析131I-SPECT/CT断层融合图像对DTC定位和定性诊断情况,同时分析131I-SPECT/CT断层融合图像结果对治疗策略的影响。所有结果均通过病理、其他影像学检查和临床随访予以证实。肿瘤的分期参照TNM分期。结果:131I-SPECT/CT断层融合显像检测出9例患者的局部淋巴结转移,明确诊断了6例颈部局部碘摄取病灶的性质,131I-WBI和131I-SPECT/CT改变了组织病理学或胸片诊断中的11例患者的术后分期,基于我科现有DTC治疗规范,131I-SPECT/CT断层融合图像改变了14例(25%)的131I治疗方案。结论:诊断剂量的131I-SPECT/CT断层融合图像可以明确131I-WBI的可疑病灶的数量,完善DTC患者的分期,改变DTC患者的131I治疗方案。
Objective：To evaluate the value of the staging of differentiated thyroid carcinomas（DTC） after the first radioiodine ablation of the residual thyroid tissue after an thyroidectomy（IAT） using diagnostic radioiodine 131I scintigraphy with SPECT/CT tomography.Methods： Fifty-six patients（40 females and 16 males）,with the average age being 35 years old,had undergone the first ablation remnant tissue therapy for more than six months or 12 months were presented for diagnostic 131I whole body scan（131I-WBI）,head and neck,chest 131I-SPECT/CT tomography fusion imaging.The results were read by two professors（one of them did not know the diseases history）.Analysis done by using 131I-SPECT/CT image to locate and qualitafy the DTC lesion in to the lesion level or not,and the results of the 131I-SPECT/CT tomography fusion image which affected the 131I therapy strategies or not were analysed.All results were compared by pathology,other imaging modalities,and clinical follow-ups for confirmation.Staging of the tumor refers to the TNM stage system.Results： The 131I-SPECT/CT tomography fusion imaging detected nine cases of patients with regional lymph node metastasis.This was definitely diagnosed six cases of patients with neck radioiodine uptake.The 131I-WBI and 131I-SPECT/CT changed the histopathology or chest X-ray diagnosis in 11 patients with post-operative staging.Based upon the existing treatment guidelines for the DTC in the department,131I-SPECT/CT tomography fusion images changed the 14 cases（25%） of 131I therapy administration.Conclusion： The diagnostic 131I of SPECT/CT tomography fusion images can reduce the number of equivocal diagnoses on 131I-WBI,improve the staging of patients with DTC,change in TNM scores,and influence the 131I treatment options.
出处
《川北医学院学报》
CAS
2012年第2期109-111,共3页
Journal of North Sichuan Medical College
基金
四川省教育厅科研项目(08ZB094)
关键词
分化型甲状腺癌
断层融合显像
肿瘤分期
TNM
Differentiated thyroid carcinoma
Tomography fusion imaging
Tumor staging
TNM
