上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

核素定位显像探查分化型甲状腺癌转移灶的临床研究

叶智轶，马 超，王 辉   

  1. 上海交通大学 医学院附属新华医院核医学科， 上海 200092
  • 出版日期:2014-01-28 发布日期:2014-01-29
  • 通讯作者: 王 辉, 电子信箱: wanghuishanghai@hotmail.com。
  • 作者简介:叶智轶（1983—）， 男， 主治医师， 硕士; 电子信箱: e-zearo-ye@hotmail.com。
  • 基金资助:

    国家自然科学基金（81271612）；上海市卫生局基金（20124016）

Detection of differentiated thyroid carcinoma metastases using radionuclide imaging

YE Zhi-yi, MA Cao, WANG Hui   

  1. Department of Nuclear Medicine， Xinhua Hospital， Shanghai Jiao Tong University School of Medicine， Shanghai 200092， China
  • Online:2014-01-28 Published:2014-01-29
  • Supported by:

    National Natural Science Foundation of China，81271612； Shanghai Municipal Health Bureau Foundation， 20124016

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摘要：

目的 探讨18-氟代脱氧葡萄糖（18F-FDG）符合线路显像与131I SPECT/CT显像在分化型甲状腺癌（DTC）转移灶探查中的应用价值。方法 对于行131I治疗和随访期间发现18F-FDG符合线路显像或131I SPECT/CT显像阳性的53例DTC患者行手术治疗，切除显像阳性灶，取得手术病理结果；比较手术前后患者的血清甲状腺球蛋白（HTg）和临床分期的变化。结果 53例患者中，18F-FDG符合线路显像和131I SPECT/CT显像阳性患者分别为34例和19例，经病理证实为甲状腺癌转移（核素显像真阳性）的患者分别为32例和17例。在49例核素显像真阳性患者中，术前血清HTg阳性38例，阴性11例；术后HTg阳性23例，阴性26例，手术前后HTg阳性率比较差异有统计学意义（P<0.05）。在18F-FDG符合线路显像真阳性的32患者中，手术后11例患者的临床分期发生改变；在131I SPECT/CT显像真阳性的17例患者中，手术后3例患者的临床分期发生改变。结论 核素定位显像是查找DTC转移灶的一种有效方法。

关键词: 分化型甲状腺癌, 18-氟代脱氧葡萄糖符合线路, 碘放射性核素, SPECT/CT

Abstract:

Objective To investigate the guiding value of 18F-fluorodeoxyglucose (18F-FDG) coincidence circuit imaging and 131I SPECT/CT imaging on detecting metastases of differentiated thyroid carcinoma (DTC). Methods Fifty-three patients with positive findings of DTC by 18F-FDG imaging or 131I SPECT/CT imaging during 131I therapy and follow-up underwent surgical resections. The preoperative and postoperative serum human thyroglobulin (HTg) and clinical stage were observed and compared. Results Among 53 patients, 34 patients were positive on 18F-FDG imaging. DTC metastases were pathologically confirmed in 32/34 patients. Nineteen patients were positive on 131I imaging, and DTC metastases were pathologically confirmed in 17/19 patients. In 49 patients with true positive DTC metastases on radionuclide imaging, 38 patients had positive serum HTg before surgery. HTg remained positive in 23/38 patients. There was significant difference of HTg before and after surgery (P<0.05). 18F-FDG and 131I imaging guided surgery changed the clinical stage for 11/32 and 3/17 patients, respectively. Conclusion 18F-FDG and 131I imaging were sensitive to detect DTC metastases.

Key words: differentiated thyroid carcinoma, 18F-fluorodeoxyglucose coincidence circuit, iodine radioisotopes, SPECT/CT