^(131)I-SPECT/CT多模态显像联合超声及血清Tg对分化型甲状腺癌颈部淋巴结转移的诊断价值  

^(131)I-SPECT/CT Fusion Imaging Combined with Ultrasonography and Serum Tg in Diagnosis of Lymph Node Metastasis in Patients with Differentiated Thyroid Cancer After ^(131)I Treatment

作　　者：夏亮[1] 陆涤宇[1] 周俊[1] 程小杰[1] 虞翌 XIA Liang LU Di-yu ZHOU Jun et al(The Central Hospital of Wuhan, Wuhan 430014, China)

机构地区：[1]武汉市中心医院,湖北武汉430014

出　　处：《肿瘤学杂志》2017年第4期278-281,共4页Journal of Chinese Oncology

摘　　要：[目的]探讨SPECT/CT多模态显像联合颈部超声及血清甲状腺球蛋白(Tg)对分化型甲状腺癌(DTC)^(131)I治疗后颈部淋巴结转移的诊断价值。[方法 ]68例DTC术后患者,^(131)I治疗前行血清Tg及颈部超声检查,^(131)I治疗后5d分别行WBS及SPECT/CT多模态显像,联合颈部超声及Tg,以病理及随访结果为诊断标准,采用χ~2检验对两种显像方法进行比较。[结果]68例DTC患者,颈部病灶共180个,SPECT/CT多模态显像检出率96.67%(174/180),WBS检出率90.56%(163/180,),差异有统计学意义(χ~2=5.26,P=0.018)。单独联合超声或Tg,以及同时联合超声和Tg时,^(131)I-SPECT/CT多模态显像对DTC术后颈部淋巴结转移灶的诊断价值与^(131)I-WBS比较差异均有统计学意义(χ~2=34.065,P<0.001;χ~2=38.246,P<0.001;χ~2=19.431,P<0.001)。灵敏度、特异性及准确性方面,^(131)I-SPECT/CT多模态显像联合超声分别为94.57%、94.31%、94.44%,^(131)I-WBS联合超声分别为78.26%、60.23%、69.44%;^(131)I-SPECT/CT多模态显像联合Tg分别为94.57%、92.05%、93.33%,^(131)I-WBS联合Tg分别为64.13%、67.05%、65.56%;^(131)I-SPECT/CT多模态显像联合超声及Tg分别为94.57%、97.73%、96.11%,^(131)I-WBS联合超声及Tg分别为66.30%、93.18%、79.44%。[结论]SPECT/CT多模态显像联合超声及血清Tg能提高DTC患者^(131)I治疗后颈部淋巴结转移病灶的检出率,明显提高颈部淋巴结转移诊断的灵敏度、特异性及准确性。[Objective] To evaluate the application of^131I-SPECT/CT fusion imaging combined with ultrasonography（US） and serum thyroglobulin（Tg） in diagnosis of cervical lymph node metastasis in patients with differentiated thyroid cancer（DTC） after-（131） I treatment. [Methods] Sixty eight patients with DTC underwent ultrasonography examination and serum Tg was measured before-（131） I treatment.^131I-whole body scan（WBS） and^131I-SPECT/CT fusion imaging were performed 5 days after-（131） I treatment. Pathological and follow-up results were used as diagnostic standard. χ^2 test was used to compare the two imaging methods. [Results] There were 180 foci of the neck in 68 patients,174 were detected by SPECT/CT fusion imaging（174/180,96.67%）,and 163 were detected by WBS（163/180,90.56%）（χ^2=5.26,P=0.018）. There were significant differences in diagnostic rate of cervical foci by combination of SPECT/CT fusion imaging with US,Tg or both,compared to by WBS（χ^2=34.065,P〈0.001;χ^2=38.246,P〈0.001;χ^2=19.431,P〈0.001）. The sensitivity,specificity and accuracy of^131I-SPECT/CT fusion imaging combined with US in detection of cervical foci were94.57%,94.31%,94.44%,those of^131I-WBS combined with US were 78.26%,60.23%,69.44%;those of^131I-SPECT/CT fusion imaging combined with Tg were 94.57%,92.05%,93.33%,those of^131I-WBS combined with Tg were 64.13%,67.05%,65.56%;those of^131I-SPECT/CT fusion imaging combined with US and Tag were 94.57%,97.73%,96.11%,those of^131I-WBS combined with both two were 66.30%,93.18%,79.44%. [Conclusions] SPECT/CT fusion imaging combined with both US and Tg can improve the diagnostic accuracy of cervical foci for DTC patients after-（131） I treatment.

关 键 词：^131I-SPECT/CT断层融合显像 ^131I全身显像 分化型甲状腺癌 放射性同位素 

分 类 号：R736.1[医药卫生—肿瘤]