上海交通大学学报（医学版）

›› 2013, Vol. 33 ›› Issue (2): 174-.doi: 10.3969/j.issn.1674-8115.2013.02.009

• 论著（临床研究） • 上一篇    下一篇

18F-FDG符合线路显像在Tg阳性、131I显像阴性分化型甲状腺癌转移灶中的应用价值

姚小芹, 王 辉, 马 超, 傅宏亮   

  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:2013-02-28 发布日期:2013-03-07
  • 通讯作者: 王 辉, 电子信箱: wanghuishanghai@hotmail.com。
  • 作者简介:姚小芹（1984—）, 女, 硕士生；电子信箱: yaolaiyang@126.com。
  • 基金资助:

    国家自然科学基金（81271612）

Clinical value of 18F-fluorodeoxyglucose dual-head coincidence imaging in metastasis of differentiated thyroid cancer with positive Tg and negative 131I scan

YAO Xiao-qin, WANG Hui, MA Chao, FU Hong-liang   

  1. Department of Nuclear Medicine, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200092, China
  • Online:2013-02-28 Published:2013-03-07
  • Supported by:

    National Natural Science Foundation of China, 81271612

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摘要：

目的 探讨18-氟代脱氧葡萄糖(18F-FDG)符合线路显像在甲状腺球蛋白（Tg）阳性、131I显像阴性分化型甲状腺癌转移灶中的应用价值。方法 选择甲状腺切除术后131I清除残余甲状腺组织治疗成功，随访中血清Tg增高、131I全身显像未发现病灶的35例分化型甲状腺癌患者行18F-FDG符合线路显像，显像结果与手术切除标本或穿刺活检的病理结果和持续随访（Tg、B超、CT和MRI等）结果进行比较，获得18F-FDG符合线路显像在诊断Tg阳性、131I显像阴性分化型甲状腺癌转移灶中的敏感度、特异度、准确度和阳性预测值。结果 35例患者中，27例最终被病理检查或持续随访证实为甲状腺癌转移。18F-FDG 符合线路显像的敏感度为81.5%（22/27），特异度为75.0%（6/8），准确度为80.0%（28/35），阳性预测值为91.7%（22/24）。18F-FDG 符合线路显像诊断Tg阳性、131I显像阴性分化型甲状腺癌转移灶与病理检查、持续随访结果的一致性较好（κ=0.499，P=0.006）。结论 18F-FDG符合线路显像在Tg阳性、131I显像阴性分化型甲状腺癌转移灶的定位和定性诊断中具有重要价值。

关键词: 分化型甲状腺癌, 18-氟代脱氧葡萄糖符合线路, 甲状腺球蛋白, 131I

Abstract:

Objective To investigate the clinical value of 18F-fluorodeoxyglucose (18F-FDG) dual-head coincidence imaging in metastasis of differentiated thyroid cancer with positive thyroglobulin (Tg) and negative 131I scan. Methods Thirty-five patients with differentiated thyroid cancer and positive Tg and negative 131I whole-body scan after thyroidectomy were included. 18F-FDG dual-head coincidence imaging was performed in all the patients for the detection of metastatic lesions. The 18F-FDG imaging results were compared with pathological findings or results of continuous follow-up by Tg and other imaging modalities such as B ultrasound, CT and MRI. The sensitivity, specificity, accuracy and positive diagnosis value of 18F-FDG dual-head coincidence imaging in patients with differentiated thyroid cancer and positive Tg and negative 131I scan were obtained. Results Twenty-seven patients with metastatic differentiated thyroid cancer were confirmed by pathological examinations or continuous follow-up. The sensitivity, specificity, accuracy and positive diagnosis value of 18F-FDG dual-head coincidence imaging were 81.5%（22/27）, 75.0%（6/8）, 80.0%（28/35) and 91.7%（22/24) respectively. 18F-FDG dual-head coincidence imaging was well in line with pathological examinations and continuous follow-up in diagnosis of metastatic lesions in differentiated thyroid cancer with positive Tg and negative 131I scan (κ=0.499, P=0.006). Conclusion 18F-FDG dual-head coincidence imaging plays an important role in the diagnosis of differentiated thyroid cancer with positive Tg and negative 131I scan.

Key words: differentiated thyroid cancer, 18F-fluorodeoxyglucose dual-head coincidence, thyroglobulin, 131I