甲状腺乳头状癌^(131)I治疗后显像结果的临床观察  

Clinical Observation of Imaging Results After Treatment of Thyroid Papillary Carcinoma ^(131)I

作　　者：姚宇 刘江波[2] YAO Yu;LIU Jiangbo(Department of Nuclear Medicine,Xinyang Central Hospital,Xinyang Henan 464000,China;Department of Breast Surgery,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang Henan 471000,China)

机构地区：[1]信阳市中心医院核医学科,河南信阳464000 [2]河南科技大学第一附属医院乳腺外科,河南洛阳471000

出　　处：《临床研究》2024年第2期128-130,共3页Clinical Research

摘　　要：目的分析甲状腺乳头状癌^(131)I治疗后的^(131)I全身平面显像以及SPECT/CT断层显像结果。方法回顾性分析2020年3月至2022年3月信阳市中心医院收治甲状腺乳头状癌术后采取^(131)I治疗的患者共86例的临床资料,所有患者均在用药^(131)I治疗后开展^(131)I全身平面显像以及SPECT/CT断层显像,观察所有患者^(131)I治疗后的显像结果;所有患者均开展6个月以上随访,将活检病理或者长期随访结果作为金标准,统计并比较两种显像方法对于转移灶的诊断准确度、敏感度、特异度、阳性预测值和阴性预测值。结果86例患者中,^(131)I治疗后开展^(131)I全身平面显像发现82例存在异常^(131)I有关浓聚灶,占比是95.35%;开展SPECT/CT断层显像发现86例存在异常的^(131)I浓聚灶,占比是100.00%,经诊断全部确诊为术后甲状腺残留;活检病理或者长期随访显示转移36例,未转移50例;^(131)I全身平面显像发现转移46例,无转移40例;SPECT/CT断层显像发现转移38例,无转移48例。SPECT/CT断层显像对于转移灶的诊断准确度、敏感度、特异度、阳性和阴性预测值是95.35%、97.22%、94.00%、92.11%、97.92%,高于^(131)I全身平面显像69.77%、77.78%、64.00%、60.87%、80.00%,差异有统计学意义(P<0.05)。结论和^(131)I全身平面显像相比,甲状腺乳头状癌^(131)I治疗后开展SPECT/CT断层显像能更好观察到患者^(131)I异常浓聚灶和明确甲状腺残留情况,同时提升对转移灶的诊断效能。Objective To analyze the results of ^(131)I whole body plane imaging and SPECT/CT tomography after treatment of papillary thyroid carcinoma ^(131)I.Methods The clinical data of 86 patients with papillary thyroid cancer treated with ^(131)I after operation in Xinyang Central Hospital from March 2020 to March 2022 were retrospectively analyzed.All patients were treated with ^(131)I whole-body imaging and SPECT/CT tomography,and the imaging results of all patients were observed after ^(131)I treatment.All patients were followed up for more than 6 months,and the results of biopsy pathology or long-term follow-up were used as the gold standard.The diagnostic accuracy,sensitivity,specificity,positive predictive value,and negative predictive value of the two imaging methods for metastatic lesions were statistically compared.Results Among the 86 patients,82 cases of abnormal ^(131)I-related concentration were found by ^(131)I whole-body imaging after treatment,accounting for 95.35%.SPECT/CT imaging showed that 86 cases had abnormal ^(131)I concentration,accounting for 100.00%.All of them were diagnosed as thyroid residual after the operation.Biopsy pathology or long-term follow-up showed metastasis in 36 cases and no metastasis in 50 cases.^(131)I whole-body imaging showed metastasis in 46 cases and no metastasis in 40 cases.SPECT/CT imaging showed metastasis in 38 cases and no metastasis in 48 cases.The diagnostic accuracy,sensitivity,specificity,and positive and negative predictive values of SPECT/CT for metastasis were 95.35%,97.22%,94.00%,92.11%,and 97.92%,which were higher than those of ^(131)I whole-body imaging(69.77%,77.78%,64.00%,60.87%,80.00%),the difference was statistically significant(P<0.05).Conclusion Compared with ^(131)I whole-body imaging,SPECT/CT imaging after treatment of papillary thyroid carcinoma ^(131)I can better observe the abnormal concentration of ^(131)I and determine the thyroid residual status,and improve the diagnostic efficiency of metastatic lesions.

关 键 词：甲状腺乳头状癌 ^(131)I治疗 SPECT/CT断层显像 准确度 敏感度 特异度 

分 类 号：R581[医药卫生—内分泌]