^(131)I-SPECT/CT与^(131)I-WBI对分化型甲状腺癌转移灶的诊断价值比较

COMPARISON OF THE ^(131)I-SPECT/CT FUSION IMAGES AND ^(131)I-WBI IN DETECTING THE METASTASES OF DIFFERENTIATED THYROID CARCINOMA

目的探讨131I-单光子发射型计算机断层显像-计算机断层摄影(131I-SPECT/CT)同机融合显像与131I-全身显像(131I-WBI)对分化型甲状腺癌(DTC)病人术后头颈部及纵隔部转移灶的诊断价值。方法对30例术后DTC头颈部及纵隔部转移的病人,口服131I 185~370 MBq诊断剂量后24~48 h,分别进行131I-WBI和131I-SPECT/CT同机融合显像,显像结束后将二者检查结果进行回顾性分析并加以比较。结果131I-SPECT/CT融合显像检查发现DTC转移灶106处,占93.0%(106/114),有8处转移灶显示为阴性,占7.0%(8/114),无假阳性病灶1。31I-WBI检查发现DTC转移灶93处,占81.6%(93/114),有21处DTC转移灶显示为阴性,占18.4%(21/114),有13处假阳性转移灶。两种结果比较,差别有显著性(χ2=6.68,P<0.01)。结论131I-SPECT/CT融合显像能较准确检出、定位DTC转移灶和除外假阳性结果,更有益于DTC病人术后头颈及纵隔部转移灶的诊断和鉴别诊断。

Objective To compare the diagnostic value of 131^I-SPECT/CT fusion images and 131^I-WBI in detecting the metastases of differentiated thyroid carcinoma （DTC） of the regions of the head, neck and mediastinum. Methods 131^I-SPECT/ CT fusion images and 131^I-WBI were taken for 30 patients with DTC confirmed surgically, 24-48h after taking a diagnostic dose of 131^I 185-370 MBq. A retrospective analysis and comparison of diagnostic value of the techniques were carried out. Results For 131^I-SPECT/CT fusion imaging, 106 metastatic lesions were detected among the total of 114 （93. 0%）, while eight of them were failed to be visualized （7.0%）, No false positive result was found; for 131^I-WBI, 93 （81.6%） metastatic lesions were identified, 21 were not visualized （18.4 %） with 13 false positive loci. 131^I-SPECT/CT confirmed more metastatic lesions than 131^I-WBI did （Х^2 = 6.68,P〈0.01）. Conclusion 131^I-SPECT/CT fusion imaging is a better method than 131^I-WBI in detection of the metastatic lesions of differentiated thyroid carcinoma.