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。

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.