摘要
目的探讨SPECT及PET显像在诊断甲状腺癌放射治疗后复发和转移中的应用价值。方法对103例接受131I治疗的分化型甲状腺癌(DTC)患者的核医学显像资料、影像学资料及血浆Tg、TSH的水平测定结果进行分析,其中的85例为有效病例,作为本研究的研究对象,分为实验组和对照组,实验组行131I SPECT/CT、131I-WBS显像,对照组行124I-PET和FDG SPECT/CT显像,并同期测定患者的血浆Tg、TSH水平及常规检查,同时让患者口服重组人促甲状腺激素(rhTSH)后再次显像,分析其显像资料及血浆Tg、TSH水平,结合患者的临床表现,综合分析患者同期的各项影像学检查结果(131I SPECT/CT断层显像、18F-FDG显像、CT、B超、MRI等)及血清TSH、Tg水平测定值,对患者是否发生分化型甲状腺癌术后转移复发进行判断,并以此做出诊断。血浆Tg水平诊断肿瘤复发转移的判断阈值为>10 ng/mL。结果以Tg血浆水平>10 ng/mL做为肿瘤复发转移判断界值得出SPECT/CT较131I全身显像具有更高的灵敏度;124I-PET较131 I-WBS有着更好的空间分辨率和灵敏度,可提高DTC定位诊断的准确性;18F-FDGPET/CT显像对Tg水平明显增高的甲状腺癌复发和转移患者有重要的诊断价值;服rhTSH可进一步提高18F-FDG检查的准确性。结论 131I SPECT-PET显像,可提高病灶定位的准确性,为肿瘤预后的评价提供了更准确的判断依据,将进一步推动分化型甲状腺癌临床诊疗水平的提升。
Objective Probe into he using valueof SPECT and PET while recuring and shifting after diagnosing the cancer radiotherapy of Differentiated Thyroid Carcinoma. Methods This research accepts division type thyroid gland cancer of 131 I treatment in the nuclear medicine of our institute to 103 during the period from December of 2003 to January of 2009 （ DTC）, nuclear medicine of patient apparent to study like materials,image materials and blood plasma Tg,level of TSH determine result analyze, 85 among them are effective case, divided into an experi- ment group and control group as the research object of this research, Group competent 131I SPECT/CT, 131I --WBS looks like the experiment ap- parently,the control ＇group competent 124I- PET and FDG SPECT/CT looks like apparently, and determine the patients blood plasma Tg, TSH level and routine inspection in the same term, Let patient oral administration recombinate people urge thyroid gland hormone again apparent to look like at the same time, it is analyzed that it looks like materials, blood plasma Tg,TSH level apparently, combine the patientg clinical mani- festation,the comprehensive analysis patient studies the inspection result in every, image in the same period （131 SPECT/CT, not the apparent in fault like, 18F - FDG apparent to look like, CT, Ultrasonography B, MRI, etc. ） and serum TSH, Tg level last definite value, Happen patient thyroid gland of splitting up etc. cancer shift, recur, go on,judge while being postoperative, so as to make diagnosis. The blood plasma Tg level is diagnosed tumour recurs the judgement threshold value shifted is 〉 10 ng/ml. Results Regard Tg blood plasma level 〉 10 ng/ml as tumour recur, shift,judge circle worth, appear SPECT/CT to be all over apparent to look like, have high sensitivity than 131i; 1241 _ PET have fine space resolution ratio and sensitivity than ＇3~I -WBS ,improve DTC make a reservation accuracy that diagnose; 18F -FDGPET/CT apparent to look like, recur and shift to Tg thyroid gland cancer that level increase obviously patient have important diagnosis value; Obeying rhTSH can further improve the accuracy of 18F -FDG checks. Conclusion 1311 SPECT/PET looks like apparently, but improve the accuracy that the focus makes a reservation, offers more accurate judgement basis for appraisal of the tumour prognosis, promote person who split up thyroid gland cancer clinical to make a diagnosis promotion of competence further.
出处
《河南外科学杂志》
2012年第4期12-15,共4页
Henan Journal of Surgery
