| 周飞华徐海峰△ 巴红珍魏龙晓.18F-FDG PET 和治疗量131I 全身扫描对分化型甲
状腺癌根治术后转移灶检测的临床价值评估[J].,2012,12(3):489-492 |
| 18F-FDG PET 和治疗量131I 全身扫描对分化型甲
状腺癌根治术后转移灶检测的临床价值评估 |
| Assessment of the Clinical Value on 18F-FDG PET and131IWhole Body Scanfor Detecting the Metastases in Differentiated Thyroid CancerAfter Operation |
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| DOI： |
| 中文关键词: 分化型甲状腺癌 单光子发射计算机断层 18F-FDG 正电子发射计算机断层扫描 转移灶 |
| 英文关键词: Differentiated thyroid carcinoma(DTC) SPECT 18F-FDG PET Metastatic lesion |
| 基金项目: |
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| 中文摘要: |
| 目的：探讨18F-FDG PET 显像和131I- 全身扫描（131I-WBS）SPECT 显像对分化型甲状腺癌（DTC）术后转移灶的临床诊断价值。
方法：对57 例外科术后拟行131I 治疗的DTC 患者行18F-FDG PET 全身显像和131I-WBS 扫描，观察和记录在糖代谢和碘代谢中
DTC 转移灶的定位及数量变化，并同时测定甲状腺球蛋白（Tg），促甲状腺激素释放激素（TSH）等实验室检查项目。结果：57 例
DTC 患者18F-FDG PET 显像发现真阳性20 例、假阳性3 例、真阴性31 例、假阴性3 例，其灵敏度为87.0 %，特异性为91.2 %。而
131I-WBS 扫描发现真阳性13 例、假阳性2 例、真阴性34 例、假阴性8 例，其灵敏度为61.9 %，特异性为94.4 % 。PET 显像和
131I-WBS 扫描共检出阳性病灶73 个，其中淋巴结32 个，肺5 个，纵隔6 个，骨26 个，其他部位4 个。PET 显像发现43 个阳性病
灶（58.9 %），而131I-WBS 检出30 个（41.1 %）。当Tg 水平＞10μg/L 时，随着Tg 在血清含量的增高，两种显像方法的对DTC 转移
灶的阳性检出率亦随之升高。结论：两种检查对DTC 术后转移灶的监测和131I 的治疗具有良好的互补性，18F-FDG PET 显像在Tg
阳性和131I-WBS 阴性的患者的转移灶检出上更具有优势，有重要的临床指导意义。 |
| 英文摘要: |
| Objective: To evaluate the feasibility of 18F-FDG and 131I-whole body scan (WBS) imaging for detecting the metastatic
foci of differentiated thyroid carcinoma (DTC) after operation. Methods: 57 patients with DTC underwent 131I-WBS and 18F-FDG PET
after the operation and the first 131I therapy , while the numbers and sites of metastatic foci were observed and recorded for each case.
Serum thyroglobulin (Tg) and TSH levels were detected simultaneously. Results: Among 57 cases of DTC , the true positive in 20 cases,
3 cases of false positive ,true negative in 31 cases false negative in 3 cases were found with18F-FDG PET. The sensitivity and specificity
of PET were 87.0 % and 91.2 % respectively. The 131I-WBS scan revealed 13 cases of true positive, false positive in 2 cases, 34 cases of
true negative and false negative in 8 cases. The sensitivity and specificity of 131I-WBS were 61.9 % and 94.4 % respectively. Clinically
confirmed 73 positive lesions of 57 cases with PET and131I-WBS , 18F-FDG alone showed 43(58.9 %) positive lesions while 131I was alone
showed 30 (41.1 %) positive lesions. Among 73 positive lesions , 32 lesions located in lymphnodes, 5 in lung , 6 in mediastinum, bone
26, and other parts of the four. When Tg levels ＞10 μg/L, the positive detection rate for metastases lesions of DTC was increased
along with elevated serum Tg. Conclusions: There were good complementary effects and clinical significance for detecting the metastatic
foci of DTC after operation and 131I treatment with 18F-FDG PET and 131I-WBS. 18F-FDG PET imaging have more advantages for detected
the metastatic lesions in Tg-positive and negative 131I-WBS of DTC patients. |
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