分化型甲状腺癌^(131)Ⅰ治疗后扫描的假阳性分析

Clinical analysis of false positive^(131)Ⅰtherapeutic scan in differentiated thyroid cancer

目的 分析分化型甲状腺癌13 1I治疗后扫描假阳性摄取的常见部位和摄取机制。方法 分化型甲状腺癌患者3 46例 ,口服治疗剂量13 1I后 7天进行全身13 1I扫描 ,根据临床症状、体征、13 1I全身扫描结果、血清Tg水平和其他影像学检查结果 ,判断13 1I的摄取是否为假阳性摄取。结果 胃肠道假阳性摄取 65例 ,肺部假阳性摄取 12例 ,双侧乳腺假阳性摄取3例 ,两侧腋下汗腺假阳性摄取 1例 ,肝脏显影 2 5 3例。结论 13 1I治疗后扫描发生假阳性摄取常见部位主要为胃肠道、肺部和肝脏 ;应注意甄别 ,避免使患者接受不必要的13 1I治疗。

Objective To analyze the common sites and mechanism of false positive therapeutic 131 I uptake in differentiated thyroid cancer (DTC). Methods Total 346 cases with DTC were examined with whole body 131 I scan 7 days after therapeutic 131 I administration. Diagnosis of false positive 131 I uptake depended on symptoms, signs, 131 I scan, serum thyroglobulin and other imaging investigations of the patients. Results Of the 346 cases, 65 cases were with gastrointestinal tract false positive uptake, 1 of which showed Meckel's diverticulum uptake. False positive uptake in lung was found in 12 cases. Three cases showed false positive uptake in bilateral breast, and 1 showed sweat gland uptake in bilateral axilla. Liver false positive uptake was found in 253 cases. Conclusion The common sites of false positive 131 I uptake in DTC were gastrointestinal tract, lung and liver. False positive uptake in other sites is uncommon. A systematic approach to the interpretation of 131 I whole body scan is suggested in order to prevent unnecessary treatment with 131 I.