^(18)F-FDG PET/CT在甲状腺乳头状癌术后^(131)I显像阴性中的价值  

The clinical value of PET/CT in patients with papillary thyroid cancer after operation

作　　者：潘博 汪世存 展凤麟 倪明 刘昕 

机构地区：[1]安徽医科大学附属省立医院PET/CT中心,安徽合肥230001

出　　处：《医学影像学杂志》2016年第1期28-31,共4页Journal of Medical Imaging

基　　金：安徽省科技攻关计划项目(No 1301043055)

摘　　要：目的探讨18F-FDG PET/CT在甲状腺乳头状癌全切术后131I治疗后、131I全身显像阴中的价值。方法回顾性分析2007年~2015年14例甲状腺乳头状癌术后、131I治疗后、131I全身显像阴性伴或不伴甲状腺球蛋白,怀疑复发或转移的患者PET/CT检查资料,根据摄取程度分为良性或恶性,所有病变最终有病理确认或经随访证实。结果 14例甲状腺乳头状癌中,发生在左叶4例,右叶8例,双叶2例。18F-FDG PET/CT显像提示术区及全身阴性5例,术区和/或淋巴结异常摄取9例,其中真阳性7例。转移部位分别为:双侧颌下、右颈部、右锁骨上1例;右颌下、左颈部、双肺1例;右锁骨上、右口咽旁1例;左颈部、气管左旁、胸1~4椎体1例;气管右旁1例;右颌下、左颈部、左鼻咽旁1例;左颈部、左锁骨上、右锁骨上1例;1例局部复发并远处转移。SUVmax最大值39.6,SUVmax最小值3.1,平均SUVmax 11.12±8.57。Tg升高患者8例,其中Tg最大值为1398.0ug/L,TG最小值为117.0ug/L,平均值为(377.31±488.89)ug/L,1例Tg Ab升高大于500IU/L,TG为1.38 ug/L。SUVmax与Tg之间线性相关性分析,相关系数R2=0.495,自变量系数为0.012。结论当131I全身显像阴性、血清甲状腺球蛋白增高大于32.7ug/L时,18F-FDG PET/CT显像则能发现转移或复发灶,优于131I全身显像。而131I全身显像阴性时、血清Tg小于3.9ug/L时,18F-FDG PET/CT显像并不能提供更多的诊断价值。Objective The aim of this study was to investigate the clinical value of ^18F-FDG PET/CT in patienls with lotal thyroideetomy followed by negative iodine whole-body scan. Methods From 2007 to 2015, PET/CT data of 14 cases of papillary thyroid carcinoma （PTC） after operation, after the treatment with ^131I, and negative ^131I whole body imaging, suspected recurrent or metastatic patients, were retrospectively analyzed. According to the degree of uptake, they were divided into benign or malignant lesions, all lesions confirmed by pathology or follow-up. Results 4 cases of PTC located in the left lobe of the lhyroid gland, 8 cases in the right lobe, and 2 cases in the bilateral thyroid gland. ^18 F-FDG PET/CT imaging showed the surgical site and whole body negative results in 5 cases, the operation area and/or lymph node of abnormal uptake in 9 cases. 7 were true positive. The metastatic sites were as follow bilateral submamlibular space, right cervical lymph nudes, and the right supraelavicular lymph nodes in 1 case respectively; right submandibular space, left cervical lymph nodes, right supraclavieular lymph nodes, both lung, and right parapharyngeal space in 1 case respectively; the left cervical lymph nodes, paratracheal lymph nodes, and thoracic vertebral 1 -4 involved in 1 case respectively; the right submaxillary lymph node, the left neck lymph node, and the left side of the nasopharynx lymph node in 1 case respectively; the left neck, Left supraclavicular, right supraclavicular recurrence and metastases was in 1 case respectively. The maximum SUV was 39.6, the minimum SUV was 3.1 , and an average SUV was 1. 12. Tg increased in 8 cases, of which the maximum value of Tg was 1398.0 ug/L, the minimum value of Tg was 117.0 ug/L, the average value was （377.31±488.89） ug/L, 1 case of TgAb increased more than 500 IU/L, while its Tg was in normal range. Linear correlation was analyzed between SUVmax and Tg, the correlation coefficient square was 0. 495 and the coefficient of the variables was 0. 012. Conclu

关 键 词：甲状腺乳头状癌 ^131碘治疗 ^131碘全身显像 正电子发射型计算机体层扫 ^18氟-氟代脱氧葡萄糖 体层摄影术 X线计算机 

分 类 号：R736.1[医药卫生—肿瘤] R817.4[医药卫生—临床医学]