^(99m)Tc-MIBI显像对甲状腺癌疗效的评估价值

Assessment of the value of ^(99m) Tc-MIBI imaging on detection of metastasis after radioisotopic treatment of thyroid cancer

目的 利用99mTc MIBI全身显像了解甲状腺癌转移灶的部位及范围 ,同时评估13 1I治疗的疗效。方法 静脉注射99mTc MIBI 370～ 5 5 5MBq ,10min后显像 ,其结果与13 1I显像、X线片、血清Tg测定值对照 ,取99mTc MIBI显像所见放射性增强的感兴趣区与健侧相应部位比较。部分患者作摄取99mTc MIBI的颈部转移灶肿块活检及病理分析。结果 78例经13 1I治疗的甲状腺癌转移患者所作的99mTc MIBI显像阳性结果与13 1I显像、X线片及血清Tg测定值相符合 ,并且表现为转移灶摄取99mTc MIBI的量与摄取13 1I的量成反比 ,13 1I疗效差的转移灶摄取13 1I量较低 ,而摄取99mTc MIBI量较高。结论 甲状腺癌转移灶用99mTc MIBI显像灵敏度高 ,而且可相对推测转移灶的细胞分化程度及13 1I的疗效 。

Objective The 99m Tc MIBI imaging not only can detect the metastatic lesion of the thyroid carcinoma, but also is a new method to assess the curative effect of 131 I against the thyroid carcinoma. Methods We compared the result of 99m Tc MIBI (the dose by venous injection was 370 555MBq, in 10 mins) with 131 I imaging, X ray and serum TG value. We also chose the interesting part of 99m Tc MIBI and 131 I concentrated area to compare with those of the normal side. Some patients also performed tumor biopsy in the radiative concentrative area of the neck region. These results were compared with the amount of 99m Tc MIBI and 131 I, absorbed by the tumor. Results In 78 patients with the metastatic lesion of thyroid carcinoma, the results of 99m Tc MIBI imaging were in accordance with those of 131 I imaging, X ray and the serum TG value. And the amount of 99m Tc MIBI absorbed by metastatic lesion was inversely proportional to that of 131 I. Cases with poor effect with 131 I, the amount absorbed by the metastatic focus was less with 131 I but more with 99m Tc MIBI. Conclusion The sensitivity of 99m Tc MIBI is higher for detecting metastatic lesion of thyroid cancer and has better assessment of cell differentiation of the metastatic foci and effective ness of 131 I treatment.