^(131)I SPECT/CT显像对分化型甲状腺癌术后转移灶的诊断价值  

The Value of^(131)I SPECT/CT Imaging in the Diagnosis of Metastases of Differentiated Thyroid Carcinoma

作　　者：杨世坚 王梓延 许妙瑜 胡巍 陈荣君 Yang Shijian;Wang Ziyan;Xu Miaoyu;Hu Wei;Chen Rongjun(Department of Nuclear Medicine,The Sixth Affiliated Hospital of Guangzhou Medical University(Qingyuan Peoples' Hospital),Qingyuan,Guangdong 511518)

机构地区：[1]广州医科大学附属第六医院(清远市人民医院)核医学科,广东清远511518

出　　处：《现代医用影像学》2022年第3期447-452,共6页Modern Medical Imageology

基　　金：2019年度清远市社会发展领域自筹经费科技计划项目(序号:123)。

摘　　要：目的:对比^(131)I-WBS与^(131)I SPECT/CT融合显像对分化型甲状腺癌(DTC)术后转移灶的诊断价值。方法:回顾性分析2018年9月-2020年8月于本院核医学科服用治疗剂量^(131)I的280例分化型甲状腺癌患者的临床资料。所有患者均接受^(131)I治疗3 d后行^(131)I-WBS与颈胸SPECT/CT(后根据^(131)I平面显像来决定是否行其他部位SPECT/CT断层融合显像检查)。以临床综合诊断结果作为最终诊断依据,采用kappa分析分别比较^(131)I SPECT/CT平面显像技术和1311 SPECT/CT断层显像技术诊断DTC转移灶的结果一致性。结果:^(131)I-WBS诊断DTC转移灶的灵敏度、特异度、准确度、阳性预测值、阴性预测值分别为89.3%、83.3%、88.2%、96.2%、62.5%,与随访金标准结果一致性为中、高度(kappa值为0.642,P<0.05)。SPECT/CT融合显像诊断DTC转移灶的灵敏度、特异度、准确度、阳性预测值、阴性预测值分别为92.4%、96.6%、93.1%、99.2%、73.7%,与随访金标准结果一致性极好(kappa值为0.793,P<0.05)。结论:SPECT/CT融合显像有助于判断DTC转移灶位置及数量,有助于排除假阳性结果和假阴性结果,从而了解病情。Objective:To compare the diagnostic value of^(131)I-WBS and^(131)I SPECT/CT fusion imaging in postoperative metastasis of differentiated thyroid carcinoma.Methods:Clinical data of 280 patients with DTC who received a therapeutic dose of^(131)I in the Department of Nuclear Medicine from September 2018 to August 2020 were retrospectively analyzed.All patients received^(131)I treatment and underwent^(131)I-WBS and SPECT/CT 3 days later.Kappa analysis was used to compare the consistency of^(131)I SPECT/CT and^(131)I SPECT/CT in the diagnosis of DTC metastases using clinical comprehensive diagnosis results as the final diagnostic basis.Results:The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of^(131)I-WBS in the diagnosis of DTC metastatic lesions were 89.3%,83.3%,88.2%,96.2%and 62.5%,respectively,and the consistency with the gold standard results was medium and high(Kappa value was 0.642,P<0.05).The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of SPECT/CT fusion imaging in the diagnosis of DTC metastasis were 92.4%,96.6%,93.1%,99.2%and 73.7%,respectively,which were in good agreement with the gold standard of follow-up(Kappa value was 0.793,P<0.05).Conclusion:SPECT/CT fusion imaging helps to determine the location and number of DTC metastases,and helps to eliminate false positive and false negative results,so as to understand the disease.

关 键 词：^(131)I平面显像 SPECT/CT 分化型甲状腺癌 

分 类 号：R736.1[医药卫生—肿瘤]