RAIU测定参数结合SPECT功能显像对甲亢^(131)I治疗剂量评估的临床价值  

The clinical value of RAIU measurement parameters combined with SPECT functional imaging in assessing the^(131)I therapeutic dose for hyperthyroidism

作　　者：郑皓 冯成涛 赵继华 王梓延 章艺蓉 王学红[1] 冯娇娇 朱高红[1] ZHENG Hao;FENG Cheng-tao;ZHAO Ji-hua(Department of Nuclear Medicine,First Affiliated Hospital of Kunming Medical University,Kunming 650032,China;不详)

机构地区：[1]昆明医科大学第一附属医院核医学科,云南昆明650032

出　　处：《中国医学装备》2021年第5期51-55,共5页China Medical Equipment

基　　金：国家自然科学基金(81860313)“^(177)Lu-CNP-iRGD纳米探针示踪靶向甲状腺乳头状癌淋巴结转移灶的研究”;昆明医科大学研究生创新基金(2020S130)“^(18)F-FDGPET/CT在分化型甲状腺癌患者术后Tg或TgAb阳性伴131I显像阴性的临床价值研究”。

摘　　要：目的:探讨甲状腺放射性碘^(131)(^(131)I)摄取(RAIU)测定参数结合单光子发射型电子计算机断层扫描(SPECT)甲状腺显像对甲状腺机能亢进症(甲亢)^(131)I治疗剂量评估的临床价值。方法:选取医院收治的132例^(131)I治疗的甲亢患者,采用SPECT常规测量甲状腺重量,并根据解剖重量、功能重量和综合评估重量3种方法进行甲状腺重量计算,依据每种方法计算的甲状腺重量将患者分为<25 g组(32例)、25~40 g组(36例)、40~60 g组(32例)和>60 g组(32例)。使用甲状腺功能测定仪(甲吸仪)测量所有患者口服^(131)I后2 h、4 h和24 h于8.5 cm、13 cm及18 cm检测距离的RAIU,采用不同重量计算方法评估甲亢^(131)I治疗活度。结果:在服用Na^(131)I后2 h、4 h和24 h的3个时间点,<25 g组、25~40 g组、40~60 g组和>60 g组4组甲吸仪在8.5 cm、13 cm和18 cm的相同工作距离参数下所测RAIU比较,差异均有统计学意义(F2 h=59.715,F=67.523,F=64.502;F4 h=67.450,F=78.270,F=65.425;F_(24 h)=48.635,F=38.307,F=43.098;P<0.01);<25 g组、>60 g组在8.5 cm、13 cm和18 cm测量工作距离参数下所测RAIU比较,差异均有统计学意义(F_(<25 g组)=3.254,F=3.824,F=7.104;F_(>60 g组)=5.604,F=4.939,F=6.931;P<0.05);<25 g组、>60 g组在甲吸仪工作距离为18 cm时所测得的RAIU均显著高于8.5 cm。在解剖重量、功能重量和综合评估重量3种计算方法下,<25 g组、25~40 g组、40~60 g组和>60 g组4组甲吸仪在8.5 cm、13 cm和18 cm的相同工作距离参数下所测RAIU计算得到^(131)I治疗活度比较,差异均有统计学意义(F_(解剖)=207.781,F=207.904,F=231.516;F_(功能)=143.475,F=136.560,F=169.575;F_(综合)=197.658,F=194.809,F=247.637;P<0.01);<25 g组、>60 g组在8.5 cm、13 cm和18 cm测量工作距离参数下计算得到的^(131)I治疗活度比较,差异均有统计学意义(F_(<25g组)=3.203,F=2.968,F=5.517;F>60g组=3.763,F=3.276,F=3.229;P<0.05),<25 g组、>60 g组在甲吸仪工作距离为18 cm时计算得到的^(131)I治疗活�Objective:To investigate the clinical value that the measurement parameters of radioactive iodine-^(131)uptake(RAIU)combined with thyroid imaging of single photon emission computed tomography(STECT)in assessing the^(131)I therapeutic dose for hyperthyroidism.Methods:A total of 132 patients with hyperthyroidism were treated by^(131)I in hospital were selected.The weight of thyroid was routinely measured by SPECT,and it was calculated according to three methods:anatomical weight,functional weight and the weight of comprehensive assessment.These patients were divided into<25g group(32 cases),25~40g group(36 cases),40~60g group(32 cases)and>60 g group(32 cases)according to the weight of thyroid that were calculated by each method.^(131)I thyroid function tester was used to measure RAIU at three distances(8.5 cm,13 cm and 18 cm)at 2 h,4 h and 24 h after^(131)I was taken orally by all patients.Different weight calculation methods were used to assess^(131)I therapeutic activity of hyperthyroidism.Results:After Na^(131)I was taken orally,the differences of RAIU at three distances(8.5 cm,13 cm and 18 cm)and three time points(2 h,4 h and 24 h)among<25g group,25-40g group,40-60g group and>60g group were significant(F_(2h)=59.715,F=67.523,F=64.502;F_(4h)=67.450,F=78.270,F=65.425;F_(24h)=48.635,F=38.307,F=43.098,P<0.01).The differences of RAIU at three distances between<25g group and>60g group were significant(F_(<25g group)=3.254,F=3.824,F=7.104;F_(>60g group)=5.604,F=4.939,F=6.931;P<0.05).The RAIUs of<25g group and>60g group at 18cm was significantly higher than those at 8.5 cm.Under three different calculation methods(anatomical weight,functional weight and the weight of comprehensive evaluation),the differences of^(131)I therapeutic activity at same working distance among<25g group,25~40g group,40~60g group and>60 g group were significant(F_(anatomy)=207.781,F=207.904,F=231.516;F_(function)=143.475,F=136.560,F=169.575;F_(comprehensive)=197.658,F=194.809,F=247.637;P<0.01).The differences of^(131)I therapeutic activity calc

关 键 词：工作距离参数 甲状腺摄^(131)I率(RAIU) 功能重量 甲亢 ^(131)I治疗活度 

分 类 号：R581.1[医药卫生—内分泌]