第二眼超声诊断乳头状甲状腺癌^(131)I治疗后颈部SPECT/CT异常摄碘灶性质

Second-eye ultrasound in diagnosis of the iodine uptake lesions in SPECT/CT in thyroid cancer patients after ^(131)I treatment

目的探讨第二眼超声诊断乳头状甲状腺癌131I治疗后颈部SPECT/CT显像中异常摄碘灶性质的价值。方法对41例颈部SPECT/CT中见异常摄碘灶的131I治疗后乳头状甲状腺癌患者行SPECT/CT引导下第二眼超声扫查,判断其良恶性,根据细针穿刺细胞学检查(FNAC)或随访结果进行确诊。结果对11例行FNAC:7例确诊为淋巴结转移,第二眼超声诊断其中6例为淋巴结转移、1例为良性,4例FNAC确诊为良性,第二眼超声均诊断为良性。对30例持续随访:8例第二眼超声诊断为正常淋巴结,其中6例随访诊断为良性,2例随访诊断为淋巴结转移;7例第二眼超声诊断为转移淋巴结,其中3例随访诊断为良性,4例随访诊断为复发或转移;15例第二眼超声未见病灶,随访诊断为良性。结论SPECT/CT引导下第二眼超声可提高诊断甲状腺癌131I治疗后淋巴结转移或复发的准确率。

Objective To evaluate the value of the second-eye ultrasonography in diagnosis of the iodine uptake lesions in SPECT/CT in patients with thyroid carcinoma after ^131 I treatment.Methods Totally 41 thyroid carcinoma patients after ^131 I treatment with iodine uptake lesions in the neck in SPECT/CT underwent SPECT/CT guided second-eye ultrasound to diagnose the benign and malignant of the lesions.The nature of the lesions were confirmed by fine needle aspiration cytology（FNAC）and follow-up.Results There were 11 receiving FNAC.Among them,7were diagnosed as metastatic lymph nodes in which 6were diagnosed as metastatic lymph nodes 1was diagnosed as benign lesions by second-eye ultrasound,4were diagnosed as benign lesions which were all diagnosed by second-eye ultrasound correctly.There were 30 being seen for follow-up,among them 8were shown as normal lymph node by second-eye ultrasound in which 6were diagnosed as benign and 2were diagnosed as metastasis or recurrence during follow-up,7were shown as metastasis in which 3were diagnosed as benign and 4were diagnosed as metastasis or recurrence during follow-up,15 showed no lesions which were diagnosed as benign during follow-up.Conclusion SPECT/CT guided second-eye ultrasound can improve the diagnostic accuracy of metastatic or recurrence in thyroid carcinoma after ^131 I treatment.