治疗剂量^(131)ISPECT/CT在评价分化型甲状腺癌(DTC)局部淋巴结转移中的价值  

Clinical Value of Radioiodine ^(131)I Ablation with SPECT/CT Fusion Imaging for Evaluating Lymph Node Metastasis in Differentiated Thyroid Cancer

作　　者：常伟[1] 韩星敏[1] 王瑞华[1] 刘保平[1] 牛广君[1] 张晶晶[1] CHANG Wei;HAN Xing-min;WANG Rui-hua(Department of Nuclear Medicine,First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,Henan Province,China)

机构地区：[1]郑州大学第一附属医院核医学科,河南郑州450052

出　　处：《中国CT和MRI杂志》2018年第8期34-36,共3页Chinese Journal of CT and MRI

摘　　要：目的治疗剂量^(131)ISPECT/CT在评价分化型甲状腺癌(DTC)局部淋巴结转移中的价值。方法回顾性分析我院2016年1月-2017年12月收治的100例分化型甲状腺癌患者临床资料。应用SPECT/CT、多层螺旋CT扫描检查。结果 ^(131)I-WBS结果:300例患者中有110例患者为单纯甲状腺残留,转移95例,完全去除20例。阳性病灶共680枚,残留病灶330枚,转移病灶350枚,其中颈部或纵隔淋巴结转移140枚,远处转移210枚。SPECT/CT断层融合显像结果:300例患者经SPECT/CT诊断后发现,单纯甲状腺残留有120例患者,转移病例有104例,共有712枚阳性病灶,甲状腺残留病灶378枚,转移病灶410枚,其中颈部或纵隔淋巴结转移160枚,远处转移250枚。患者有淋巴结转移者,通常是在^(131)I治疗后随访观察淋巴结有无缩小、增大或者消失,如有复发者,才行穿刺活检继而手术治疗。二合并肺、骨等远处转移者,SPECT-CT都是阳性,即可确诊,无需手术病理。SPECT/CT诊断DTC转移病灶灵敏度、特异性、准确性显著高于^(131)IWBI(P<0.05)。SPECT/CT淋巴结数、远处转移、淋巴结检出率、远处转移检出率显著高于^(131)I-WBI(P<0.05)。结论 SPECT/CT能显著提高分化型甲状腺癌局部淋巴结转移诊断率,值得推荐使用。Objective To investigate the clinical value of radioiodine ^（131）I ablation with SPECT/CT fusion imaging for evaluating lymph node metastasis in differentiated thyroid cancer（DTC）. Methods The clinical data of 100 patients with DTC who were admitted to our hospital from January 2016 to December 2017 were retrospectively analyzed, all patients underwent the SPECT/CT fusion imaging and CT examination. Results The ^（131）I-WBI showed that of the 300 patients, 110 patients had simple thyroid residuals, 95 had metastases, and 20 had been completely removed. There were 680 positive lesions including 330 residual lesions, and 350 metastatic lesions, of which 140 lymph nodes metastasis from the neck or mediastinum, and 210 cases of distant metastasis. The SPECT/CT fusion imaging showed that the there were 120 patients with residual thyroid alone and 104 cases with metastatic disease. There were 712 positive lesions, 378 residual thyroid lesions, and 410 metastatic lesions, of which 160 were cervical or mediastinal lymph node metastases and 250 distant metastases. The surgical results showed that there were 110 cases of simple thyroid residue, 104 cases of metastasis, 398 residual lesions and 413 metastatic lesions, of which 152 were cervical or mediastinal lymph node metastasis and 261 were distant metastasis. The sensitivity, specificity and accuracy of SPECT/CT in diagnosing DTC metastases were significantly higher than those in ^（131）I-WBI（P〈0.05）. The detection rate of lymph node and distant metastasis in SPECT/CT was significantly higher than that of ^（131）I-WBI（P〈0.05）. Conclusion SPECT/CT can significantly improve the diagnostic rate of regional lymph node metastasis in differentiated thyroid cancer and is worth recommending.

关 键 词：放射性131-I SPECT/CT 分化型甲状腺癌 

分 类 号：R736.1[医药卫生—肿瘤]