论文部分内容阅读
[目的]探讨分化型甲状腺癌(DTC)131I全身扫描中消化系统131I摄取的病理生理机制及其临床意义。[方法]分化型甲状腺癌术后患者1002例,其中乳头状癌743例,滤泡状癌253例,混合型106例。按卫生部核医学临床诊疗指南进行131I治疗前后处理,根据临床症状和体征,结合血清Tg水平和影像学检查(胸部X线片、CT、MRI、超声等),对131I全身扫描结果进行判读和分析。[结果]甲状腺肿瘤转移灶摄取131I16例(2.0%);病理性(非肿瘤转移)摄取2例(0.2%);生理性代谢显像鼻—口腔—唾液腺887例(88.52%),食管—胃—肠道771例(76.95%),弥漫性肝摄取689例(68.76%)。[结论]分化型甲状腺癌131I全身扫描其消化系统显像图的准确读片可避免误诊和不恰当的131I治疗。
[Objective] To investigate the pathophysiological mechanism and its clinical significance of 131I uptake in digestive system in 131I whole-body scanning of differentiated thyroid cancer (DTC). [Method] There were 1002 patients with differentiated thyroid cancer after operation, including 743 papillary carcinoma, 253 follicular carcinoma and 106 mixed type. According to the guidelines of clinical diagnosis and treatment of nuclear medicine by Ministry of Health, 131I treatment before and after treatment, according to clinical symptoms and signs, combined with serum Tg levels and imaging studies (chest X-ray, CT, MRI, ultrasound, etc.) analysis. [Results] Tumor metastasis in thyroid tumors was found in 131 cases (2.0%), pathological (non-tumor metastasis) in 2 cases (0.2%), physiological metabolic imaging in 887 cases (88.52%) of nasal-oral salivary glands, 771 cases (76.95%) of intestinal tract and 689 cases (68.76%) of diffuse liver uptake. [Conclusion] The accurate reading of the digestive system imaging of differentiated thyroid carcinoma 131I whole body scan can avoid misdiagnosis and inappropriate 131I treatment.