^(99m)Tc-MIBI显像、^(131)I-WBS和HTG测定对分化型甲状腺癌^(131)I治疗后随访的临床评价

Clinical Value of ^(99)m Tc-MIBI Imaging, ^(131) I Whole Body Scan and HTG Determination for the Follow up of Patients with Differentiated Thyroid Carcinoma after ^(131) I Therapy

为对９９ｍ Ｔｃ－ＭＩＢＩ显像、１３１Ｉ－ＷＢＳ和ＨＴＧ 测定，在分化型甲状腺癌１３１Ｉ治疗后随访中的价值进行对比研究，对５３例分化型甲状腺癌患者依次行ＨＴＧ 测定、９９ｍ Ｔｃ－ＭＩＢＩ显像和１３１Ｉ－ＷＢＳ。结果：９９ｍ Ｔｃ－ＭＩＢＩ显像的灵敏度、特异性和准确性分别为８６．３６％ 、８７．１０％ 、８６．７９％ ；ＨＴＧ 测定和１３１ Ｉ－ＷＢＳ灵敏度分别为６８．１８％ 和６３．３４％ ，特异性为１００％ ，准确性分别为８６．７９％ 和８４．９１％ 。三者联合检查总灵敏度达１００％ ，特异性和准确性分别为８７．１０％ 和９２．４５％ 。结论：９９ｍ Ｔｃ－ＭＩＢＩ显像具有较高的灵敏度。９９ｍ Ｔｃ－ＭＩＢＩ显像、１３１ Ｉ－ＷＢＳ和ＨＴＧ 测定联合检查有助于进一步提高诊断的灵敏度和准确性。

The purpose of this study was to make a comparative evaluation of 99m Tc MIBI imaging, 131 I whole body scan and HTG determination in use for the follow up of patients with differentiated thyroid carcinoma (DTC) after 131 I therapy. Fifty three patients with DTC had undergone surgical treatment and 131 I ablation. Clinical examinations showed that 22 of them had metastases or recurrences. In the follow up of all the patients, the HTG determination, the 99m Tc MIBI imaging and the 131 I WBS were performed in sequence after the discontinuance of the administration of thyroxin for 4 6 weeks. The results showed that the sensitivity, specificity and accuracy of 99m Tc MIBI imaging were 86.36%, 87.10% and 86.79% respectively; those for HTG were 68 18%, 100% and 86.79% and those for 131 I WBS were 63.64%, 100% and 84.91% respectively. The total sensitivity of the three examinations was 100%; the total specificity and total accuracy were 87.10% and 92.45% respectively. The data of this study suggest that 99m Tc MIBI imaging is a highly sensitive method and the combined use of the three examinations can improve the sensitivity and accuracy of diagnosis for patients with DTC.