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目的探讨99 TcmO-4扫描检测分化型甲状腺癌(DTC)患者术后残留甲状腺组织的价值。方法 60例DTC患者行甲状腺切除术,131I清甲治疗(RRA)前3-5d静脉注射99 TcmO-45mCi(185MBq)后,采用单光子发射计算机断层成像(SPECT)/CT行甲状腺床区扫描。口服131I 30-150mCi(1110-5550MBq)行RRA治疗,治疗后3-5d采用SPECT/CT行甲状腺床区扫描,并以131I甲状腺床区扫描阴、阳性结果作为甲状腺残留有无的金标准,比较99 TcmO-4扫描的检测灵敏度和阳性预测值。结果在病例数和残灶数方面,99 TcmO-4扫描的检测灵敏度为85%和62%,阳性预测值为100%和92%。若将99 TcmO-4扫描检测出的可疑残留均计入,灵敏度为93%和69%,阳性预测值为100%和81%。结论 99 TcmO-4扫描能检测出甲状腺残留组织。99 TcmO-4扫描检测为阴性结果或可疑残留时,最好再行小剂量131I甲状腺床区扫描明确诊断。
Objective To investigate the value of 99 TcmO-4 in the detection of residual thyroid tissue in patients with differentiated thyroid carcinoma (DTC). Methods Thirty-six patients with DTC underwent thyroidectomy and intravenous injection of 99 TcmO-45mCi (185MBq) three to five days before 131I treatment (RRA). Thyroid gland was scanned by single photon emission computed tomography (CT). Oral 131I 30-150mCi (1110-5550MBq) line RRA treatment, 3-5d after treatment of SPECT / CT line thyroid bed scan, and 131I thyroid bed area scan positive and negative results as the thyroid residual gold standard, compare 99 TcmO-4 scan detection sensitivity and positive predictive value. Results The detection sensitivity of 99 TcmO-4 was 85% and 62% with the positive predictive value of 100% and 92%, respectively. If the suspicious residues detected by 99 TcmO-4 scan were included, the sensitivity was 93% and 69%, and the positive predictive value was 100% and 81% respectively. Conclusion 99 TcmO-4 scan can detect residual thyroid tissue. 99 TcmO-4 scan test for the negative results or suspicious residues, the best and then a small dose of 131I thyroid scan confirmed the diagnosis.