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[目的]探讨~(18)F-FDG PET/CT在高危分化型甲状腺癌~(131)I治疗后的临床应用价值。[方法 ]23例高危分化型甲状腺癌患者全切或近全切术后4周行~(131)I治疗,并在~(131)I治疗后的1周内分别行~(18)F-FDG PET/CT与~(131)I全身扫描(~(131)I-WBS),以术后病理活检或至少6个月的影像随访作为诊断标准。分析~(18)F-FDG PET/CT在随访中的临床应用价值。[结果]检查后发现16例发生转移,~(18)F-FDG PET/CT检出其中15例(93.8%),与~(131)I-WBS检出其中5例(31.3%)比较,差异有统计学意义(P=0.006)。在随访中,TNM分期改变的患者有6例(26.1%),患者管理改变有15例(56.5%)且分别为手术切除、靶向治疗、局部外照射等治疗。[结论]在临床实践中,~(18)F-FDG PET/CT能检测出~(131)I-WBS阴性病灶,具有更高的灵敏度和阴性预测值,使患者获得最佳治疗方案而改善预后。
[Objective] To investigate the clinical value of ~ (18) F-FDG PET / CT in the treatment of high-risk differentiated thyroid cancer ~ (131) I. [Method] Twenty-three cases of high-risk differentiated thyroid cancer underwent total 131I treatment 4 weeks after total or near total resection and were treated with ~ (18) F- FDG PET / CT and ~ (131) I whole body scans (~ (131) I-WBS) were used as diagnostic criteria for postoperative biopsy or imaging follow-up of at least 6 months. The clinical value of ~ (18) F-FDG PET / CT in follow-up was analyzed. [Results] After the examination, 16 cases were found to have metastasized. Among them, 15 (93.8%) were detected by 18F-FDG PET / CT and 5 (31.3%) were detected by 131I- The difference was statistically significant (P = 0.006). At follow-up, 6 (26.1%) patients had TNM staging changes and 15 (56.5%) patients had managerial changes. Surgical resections, targeted therapies, and local external irradiation were performed respectively. [Conclusion] ~ (18) F-FDG PET / CT can detect ~ (131) I-WBS negative lesions in clinical practice, with higher sensitivity and negative predictive value, so that patients receive the best treatment and improve Prognosis.