| 川玲,赵文锐,朱家瑞,许根祥,王新强,高春华,方庭正.分化型甲状腺癌131I治疗后SPECT/CT融合显像的临床研究[J].中国医学影像技术,2006,22(9):1412~1414 |
| 分化型甲状腺癌131I治疗后SPECT/CT融合显像的临床研究 |
| The usefulness of fusion images of SPECT/CT in patients with differentiated thyroid carcinoma after131I therapy |
| 投稿时间：2006-05-07 修订日期：2006-08-11 |
| DOI： |
| 中文关键词: SPECT/CT融合图像 分化型甲状腺癌 131I治疗 |
| 英文关键词:SPECT/CT fusion images Differentiated thyroid carcinoma 131I therapy |
| 基金项目: |
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| 中文摘要: |
| 目的 评价131I SPECT/CT融合图像对于分化型甲状腺癌(DTC)术后患者131I治疗后判断残留和转移病灶的存在和部位以及确定治疗计划的作用。方法 DTC患者25例(50例次)于131I治疗后5~7天行131I SPECT/CT全身和局部断层显像。131I治疗剂量分别为100 mCi、150 mCi和200 mCi。结果 ①治疗后131I融合图像显示:单纯残留甲状腺组织摄取131I 13次(26%),残留甲状腺和颈部淋巴结6次(12%),双肺弥漫性及散在病灶4次(8%),咽喉部及残余甲状腺组织3次(6%),纵隔和颈部淋巴结1次(2%),双肺、颈部淋巴结和残余甲状腺组织13次(26%),咽喉部2次(4%),颈部淋巴结和双肺3次(6%),残余甲状腺和双肺3次(6%),残余甲状腺和骨摄取碘1次(2%),多发骨和颈部淋巴结1次(2%)。②本组DTC患者甲状腺球蛋白(Tg)>1000的12次(24%),Tg 1000~50的11次(22%),Tg<50的20次(40%),7次(14%)无Tg资料。Tg值与131I摄取灶的数量和范围有关,但是部分患者131I摄取较多而Tg仅轻度增高或正常范围。③15例(60%)在治疗1~5次后不再行131I治疗,其中11例(11/15例)治疗后根据131I融合图像未再发现病灶并结合Tg正常而不再需要治疗,其余4例治疗后同机CT显示的双肺弥漫性或散在病灶不摄取131I。结论 131I治疗后SPECT/CT融合显像有重要的临床意义,它可以明确诊断DTC的残留、转移和复发,同时为再次治疗提供依据。 |
| 英文摘要: |
| Objective To evaluate the role of the fusion of SPECT/CT images in patients with differentiated thyroid carcinoma (DTC) after 131I therapy. Methods Twenty-five patients (50 times) with DTC after thyroidectomy were studied using SPECT/CT images after 131I therapy 5-7 days. Results ① The results of 131I SPECT/CT fusion images showed 13 times (26%) radioiodine were concentrated in the remains of thyroid gland; 6 times (12%) in remains of thyroid gland and lymph node of neck; 4 times (8%) in two lung extensive and diffusive lesions; 3 times (6%) in the remains of thyroid gland and laryngopharynx; 1 time (2%) in mediastina and the lymph node of neck; 13 times (26%) in two lungs, lymph node of neck and remains of thyroid gland; 2 times (4%) in laryngopharynx; 3 times (6%) in laryngopharynx, lymph node of neck and two lungs; 1 time (2%) in remains of thyroid gland and bone; 1 time (2%) in lymph node of neck and bones. ② Twelve times (24%) concentrated 131I on lymph node of neck and two lungs on fusion imaging when serum thyroglobulin were measured >1000, eleven times (22%) and twenty times (40%) showed the extent concentrated 131I when Tg were 1000~50 or <50. There were not the information of Tg in 7 times (14%). ③ Fifteen cases (15/25, 60%) did not need to treat again after 1-5 times according to the results of 131I fusion imaging. Among them, eleven patients had no the lesion of uptake 131I on the fusion imaging and Tg was normal. The other 4 patients had no lesions on the 131I fusion imaging with Tg normal although many lesions were found on CT of the same instrument and 18F-FDG PET/CT imaging. Conclusion There was great role that 131I SPECT/CT fusion images assessed the remains of thyroid, recurrence and metastases of patients with DTC after 131I therapy. We can acquire useful treatment information using 131I fusion imaging for the next time therapy. |
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