论文部分内容阅读
目的:探讨分化型甲状腺癌(DTC)术后99 Tcm-MIBI显像结果的意义。方法:300例DTC术后患者中随机选取69例行99 Tcm-MIBI显像。2名有经验核医学医师盲法阅片。将99 Tcm-MIBI显像结果与治疗后131I显像结果比较。另对经高分辨CT或治疗后131I显像诊断肺转移和无肺转移患者行半定量分析,比较靶本底比值(T/B)。结果:排除1例死于血管肉瘤者,余按照手术方式及131I治疗情况分为3组(A组:44例甲状腺癌术后拟131I治疗组;B组:22例有再次131I治疗指征组;C组:2例甲状腺大部切除组)。A组99 Tcm-MIBI显示残余甲状腺34.1%(15/44),转移灶30.0%(6/20)。B组99 Tcm-MIBI显示复发及转移灶63.6%(7/11)。C组99 Tcm-MI-BI显示残余甲状腺100.0%(2/2),并为唯一一种发现颈部转移显像方法。5例患者同时存在多种性质转移灶:MI-BI+I-,MIBI-I+及MIBI+I+。肺转移与无肺转移患者T/B比值差异无统计学意义。结论:99 Tcm-MIBI可发现分化好及失分化病灶,联合131I显像为DTC术后患者选择治疗方式提供重要信息,有临床应用价值。
Objective: To investigate the significance of 99 Tcm-MIBI imaging after differentiated thyroid cancer (DTC). Methods: Ninety-nine patients underwent 99 Tcm-MIBI imaging in 300 DTC patients. Two experienced nuclear medicine physicians blinded readings. The 99 Tcm-MIBI imaging results were compared with the 131 I imaging results after treatment. Another high-resolution CT or after treatment of 131I imaging diagnosis of lung metastases and non-lung metastases were semi-quantitative analysis of the ratio of the background (T / B). Results: One patient who died of angiosarcoma was excluded and divided into three groups according to the operation method and 131I treatment (group A: 44 cases of thyroid cancer after 131I treatment; group B: 22 cases had again 131I treatment group ; C group: 2 cases of thyroidectomy group). A group 99 Tcm-MIBI showed residual thyroid 34.1% (15/44), metastasis 30.0% (6/20). 99 Tcm-MIBI in group B showed 63.6% (7/11) of recurrence and metastasis. 99 Tcm-MI-BI in group C showed 100.0% (2/2) of the residual thyroid gland, and was the only method to detect neck metastases. Five patients had multiple metastases at the same time: MI-BI + I-, MIBI-I + and MIBI + I +. There was no significant difference in T / B ratio between lung metastasis and non-lung metastasis. Conclusion: 99 Tcm-MIBI can be found differentiated and dedifferentiated lesions, combined with 131I imaging in patients with DTC postoperative choice of treatment provides important information, clinical value.