^(99m)Tc-DTPA眼眶SPECT/CT对甲状腺相关性眼病炎性活动的评价  

Evaluation of inflammatory activity in thyroid associated ophthalmopathy by SPECT/CT with ^(99m)Tc-DTPA

作　　者：刘丹[1] 许雪亮[1] 文丹[1] 谭佳[1] 蒋承志 LIU Dan;XU Xueliang;WEN Dan;TAN Jia;JIANG Chengzhi(Department of Ophthalmology;Department of Nuclear Medicine, Xiangya Hospitalj Central South Universityj Changsha 410008, China)

机构地区：[1]中南大学湘雅医院眼科,长沙410008 [2]中南大学湘雅医院核医学科,长沙410008

出　　处：《中南大学学报（医学版）》2018年第4期457-460,F0003,共5页Journal of Central South University ：Medical Science

基　　金：湖南省自然科学基金(2015JJ4093)~~

摘　　要：目的:采用^(99m)锝-二亚乙基三胺五乙酸(^(99m)Tc-diethylene triamine pentaaceticacid,^(99m)Tc-DTPA)眼眶单光子发射计算机断层成像术(single-photon emission computed tomography,SPECT)/CT对甲状腺相关性眼病(thyroid associated opthamopathy,TAO)炎性活动进行评估。方法:收集2016年10月至2017年3月就诊于中南大学湘雅医院的TAO患者48例(93眼)。依据临床活动评分(clinical active score,CAS)标准将93只眼分为TAO活动期组(n=72)和TAO非活动期组(n=21),所有的患者均行^(99m)Tc-DTPA眼眶SPECT/CT检查,以眼外肌肌腹^(99m)Tc-DTPA摄取增强为阅片阳性,比较^(99m)TcDTPA眼眶SPECT/CT与CAS评分对TAO活动性评价的准确性。结果:TAO活动期组^(99m)Tc-DTPA摄取率(uptake rate,UR)高于TAO非活动期组(P<0.01)。所有TAO患者的UR与其CAS评分呈正相关(r=0.767,P<0.01)。^(99m)Tc-DTPA眼眶SPECT/CT结果和CAS评分结果不一致的患者有5例(7只眼),其中6只眼CAS评分<3分,但^(99m)Tc-DTPA眼眶SPECT/CT结果显示眼外肌存在炎性病变;1只眼CAS评分>3分,但^(99m)Tc-DTPA眼眶SPECT/CT结果未显示任何炎性病变。结论:^(99m)TcDTPA眼眶SPECT/CT对TAO活动期的评价与CAS评分具有一致性;^(99m)Tc-DTPA眼眶SPECT/CT对TAO活动期的评价可能比CAS评分更加客观、准确。Objective： To evaluate the inf lammatory activity in thyroid associated ophthalmopathy（TAO） by 99mTc-diethylene triamine pentaaceticacid（99mTc-DTPA） orbital single-photon emission computed tomography（SPECT）/CT.Methods： A total of 48 patients were enrolled from Xiangya Hospital of Central South University between October 2016 and March 2017. According to clinical active score（CAS）, 93 eyes were divided into a TAO active group（n=72） and a TAO inactive group（n=21）. All patients underwent99mTc-DTPA orbital SPECT/CT examination, and the DTPA uptake in extraocular muscle belly was supposed to be positive. The results of 99mTc-DTPA orbital SPECT/CT examination were compared with those of CAS score evaluation.Results： The uptake rate（UR） of 99mTc-DTPA in the TAO active group was higher than that in the TAO inactive group（P0.01）. There was a linear positive correlation between UR and its CAS scores in all patients（r=0.767, P0.01）. Five cases（7 eyes） showed inconsistent results between 99mTc-DTPA orbital SPECT/CT examination and CAS score. Among the 7 eyes, 6 eyes showed myocarditis lesions in 99mTc-DTPA orbital SPECT/CT examination while its CAS was no more than 3; meanwhile, there was 1 eye with CAS3, but 99mTc-DTPA orbital SPECT/CT examination showed negative myocarditis lesions.Conclusion： 99mTc-DTPA orbital SPECT/CT is consistent with the CAS score in evaluation of the disease activity of TAO; 99mTc-DTPA orbital SPECT/CT may be more objective and accurate to evaluate TAO than CAS.

关 键 词：^99m锝-二亚乙基三胺五乙酸 单光子发射计算机断层成像术 CT 甲状腺相关性眼病 炎性分期 

分 类 号：R581[医药卫生—内分泌] R771.3[医药卫生—内科学]