桥本甲状腺炎^(18)F-FDG代谢显像研究  

The study of^(18)F-FDG metabolic imaging in Hashimoto's thyroiditis

作　　者：彰金[1] 周通[1] 祁烁[2] 李颖[1] 王红艳[1] 吴培琳 丁治国[2] ZHANG Jin;ZHOU Tong;QI Shuo;LI Ying;WANG Hong-yan;WU Pei-lin;DING Zhi-guo(Dongzhimen Hospital of Beijing University of Chinese Medicine,Beijing 100700,China;Thyropathy Hospital,SUN Si Miao Hospital of Beijing University of Chinese Medicine,Tongchuan Shaanxi 727031,China)

机构地区：[1]北京中医药大学东直门医院,北京100700 [2]北京中医药大学孙思邈医院甲状腺病院,陕西铜川727031

出　　处：《中国临床医学影像杂志》2024年第11期771-776,共6页Journal of China Clinic Medical Imaging

基　　金：陕西省重点研发项目(S2023-ZDLSF-56);北京中医药大学孙思邈研究院2021年度中医药科研计划资助项目(SSMYJY-1-2021-02,SSMYJY-1-2021-05);陕西省铜川市甲状腺病防治中心2022年度中医药科研专项项目(TJF-2022-04)。

摘　　要：目的:分析桥本甲状腺炎(Hashimoto’s thyroiditis,HT)^(18)F-FDG代谢显像的影像特点,研究甲状腺显影情况与甲状腺功能、甲状腺自身抗体(TPOAb、TGAb)滴度间的关系,探讨^(18)F-FDG代谢显像在HT诊疗中的应用价值。方法:回顾性分析2013年5月-2023年3月行^(18)F-FDG SPECT/CT符合线路代谢显像的患者,筛选HT患者。通过目测法和半定量分析法分析HT^(18)F-FDG代谢显像的特点。目测法分级标准为甲状腺不显影、甲状腺显影低于肝脏、等于肝脏、高于肝脏、明显高于肝脏,分别赋值为0~4。半定量分析方法为计算甲状腺与肝脏区放射性摄取比值(T/L)。采用线性相关分析、独立样本t检验、秩和检验等统计学方法分析甲状腺显影情况与甲状腺功能、甲状腺自身抗体(TPOAb、TGAb)滴度间的相关性。结果:共24例HT患者纳入本研究,男4例,女20例,年龄(63.50±12.93)岁,甲状腺功能减退10例,甲状腺功能正常11例,甲状腺功能亢进3例。24例HT患者中2例合并甲状腺乳头状癌伴颈部多发淋巴结转移,余22例HT患者中,除1例表现为甲状腺一叶局灶性显影外,其余21例均表现为甲状腺双叶弥漫显影。24例HT T/L值与TSH水平呈弱正相关(r=0.411,P<0.05)。甲状腺功能减退组T/L值高于甲状腺功能正常组,差异有统计学意义(t=-3.535,P<0.05)。根据TPOAb、TGAb滴度进行分层分析,TPOAb滴度<300 kU/L、300~<600 kU/L、≥600 kU/L三组T/L值依次为1.13(1.02,1.63)、1.40(1.10,1.48)、3.01(2.86,4.22),三组间差异有统计学差异(H=9.788,P<0.05),两两组间比较,TPOAb滴度≥600 kU/L组T/L值高于0~<300 kU/L组(Bonferroni校正后P<0.05),其余各组两两比较差异无统计学意义(Bonferroni校正后P>0.05)。TGAb滴度<200 kU/L、200~<500 kU/L、≥500 kU/L三组T/L值依次为1.03(1.00,1.08)、1.60(1.32,2.97)、2.01(1.09,2.91),三组间差异有统计学差异(H=8.223,P<0.05),两两组间比较,TGAb滴度<200 kU/L组T/L值小于200~<500 kU/L组(Bonferroni校正�Objective:To analyze the image characteristics of Hashimoto's thyroiditis(HT),study the correlation between thyroid images and thyroid function,thyroid autoantibodies(TPOAb,TGAb)titer.To explore the value of^(18)F-FDG metabolism imaging in the management of HT.Methods:Patients underwent I8F-FDG SPECT/CT metabolic imaging from May 2013 to March 2023 were retrospectively analyzed.The patients with HT were screened.The characteristics of thyroid imaging on I8FFDG metabolism imaging were analyzed by visual and semi-quantitative analysis.According to visual observation,the uptake of^(18)F-FDG by the thyroid is divided into levels O to 4,namely non thyroid uptake,thyroid uptake below the liver,equal to the liver,higher than the liver,and significantly higher than the liver.The semi-quantitative analysis method was to calculate the ratio of thyroid to liver radioactivity uptake(T/L).The correlation between thyroid imaging and thyroid function were analyzed by Linear correlation analysis,t test,rank sum test and other statistical methods.Results:Twenty-four patients with HT were enrolled in this study,including 4 males and 20 females,aged(63.50±12.93)years,with 10 hypothyroidism,11 euthyroidism and 3 hyperthyroidism.Two of the 24 patients were complicated with papillary thyroid carcinoma with multiple cervical lymph node metastasis,in the remaining 22 HT patients,except for 1 case with focal radioactivity accumulation in one lobe of the thyroid,the other 21 cases showed diffuse imaging in both lobes of the thyroid.There was a weak positive correlation between T/L and TSH level(r=0.411,P<0.05).The T/L values in hypothyroidism group was higher than that in euthyroid group(t=-3.535,P<0.05).Hierarchical analysis was performed according to TPOAb and TGAb titers,and T/L values had statistically significant difference in TPOAb titers among<300 kU/L,300~<600 kU/L,and≥600 kU/L groups(H=9.788,P<0.05).The T/L values in the TPOAb≥600 kU/L group was higher than those in<300 kU/L groups(Bonferroni correction P<0.05).TGAb titer<20

关 键 词：桥本病 氟脱氧葡萄糖F18 放射性核素显像 

分 类 号：R581.4[医药卫生—内分泌] R817.4[医药卫生—内科学]