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目的:探讨131I全身显像(131I-WBS)与131I单光子发射型计算机断层显像/计算机体层摄影术(131I-SPECT/CT)同机融合显像对于分化型甲状腺癌(DTC)术后131I治疗患者的诊治价值。方法:选择术后经病理证实并接受131I治疗的DTC 48例,3~5 d后同期行131I-WBS和131I-SPECT/CT断层融合显像。将131I-WBS与131I-SPECT/CT断层融合图像进行对比分析,探讨各自显像特点与临床价值。结果:48例DTC患者共行131I-WBS 48次,131I-SPECT/CT断层融合显像60次。在131I-WBS发现的总计145处摄碘灶中,甲状腺床占34.3%,恶性病灶占60.5%,非甲状腺生理性和良性病变摄取以及污染占5.2%。131I-SPECT/CT融合显像比131I-WBS多发现23处转移灶。在131I-WBS无法确诊的20例65处摄碘灶中,通过131I-SPECT/CT断层融合显像获得准确定位和定性诊断的分别占100%和94%。共使18例(37.5%,18/48)患者获得了更多的增益价值,且其中8例(44.4%,8/18)患者治疗方案发生了改变。结论:131I-WBS应常规应用于DTC术后131I治疗患者。当131I-WBS诊断不明确或者与临床表现不符时,加做131I-SPECT/CT断层融合显像在提高DTC诊断正确率、制定和调整治疗方案上具有重要临床价值。
Objective: To investigate the clinical value of 131I-WBS and 131I single-photon emission computed tomography / computed tomography (131I-SPECT / CT) fusion imaging for differentiated thyroid cancer (DTC) 131I treatment of patients with diagnosis and treatment value. Methods: 48 cases of DTC confirmed by pathology and receiving 131I were selected. 131I-WBS and 131I-SPECT / CT fusion imaging were performed at the same time after 3 ~ 5 days. The 131I-WBS and 131I-SPECT / CT fusion images were compared and analyzed to explore their imaging features and clinical value. Results: 48 patients with DTC had 131I-WBS 48 times and 131I-SPECT / CT fusion 60 times. Thyroid glands accounted for 34.3%, malignant lesions accounted for 60.5%, non-thyroid physiological and benign lesions uptake and pollution accounted for 5.2% in a total of 145 iodine-iodine lesions found on 131I-WBS. 131I-SPECT / CT fusion imaging more than 131I-WBS found 23 metastases. In 20 cases of 65 iodine-rich lesions in 131I-WBS that could not be diagnosed, accurate localization and qualitative diagnosis by 131I-SPECT / CT fusion imaging accounted for 100% and 94%, respectively. A total of 18 patients (37.5%, 18/48) gained more gain value, and 8 of them (44.4%, 8/18) changed the treatment plan. Conclusion: 131I-WBS should be routinely applied to 131I-treated patients after DTC. When 131I-WBS diagnosis is not clear or does not match with the clinical manifestations, plus do 131I-SPECT / CT fusion imaging in improving the diagnostic accuracy of DTC, to develop and adjust the treatment program has important clinical value.