分化型甲状腺癌131Ⅰ治疗后扫描的假阳性分析

目的分析分化型甲状腺癌131Ⅰ治疗后扫描假阳性摄取的常见部位和摄取机制.方法分化型甲状腺癌患者346例,口服治疗剂量131Ⅰ后7天进行全身131Ⅰ扫描,根据临床症状、体征、131Ⅰ全身扫描结果、血清Tg水平和其他影像学检查结果,判断131Ⅰ的摄取是否为假阳性摄取.结果胃肠道假阳性摄取65例,肺部假阳性摄取12例,双侧乳腺假阳性摄取3例,两侧腋下汗腺假阳性摄取1例,肝脏显影253例.结论131Ⅰ治疗后扫描发生假阳性摄取常见部位主要为胃肠道、肺部和肝脏;应注意甄别,避免使患者接受不必要的131Ⅰ治疗.

Clinical analysis of false positive 131Ⅰ therapeutic scan in differentiated thyroid cancer

Objective To analyze the common sites and mechanism of false positive therapeutic 131 I uptake in differentiated thyroid cancer (DTC). Methods Total 346 cases with DTC were examined with whole body 131 I scan 7 days after therapeutic 131 I administration. Diagnosis of false positive 131 I uptake depended on symptoms, signs, 131 I scan, serum thyroglobulin and other imaging investigations of the patients. Results Of the 346 cases, 65 cases were with gastrointestinal tract false positive uptake, 1 of which showed Meckel's diverticulum uptake. False positive uptake in lung was found in 12 cases. Three cases showed false positive uptake in bilateral breast, and 1 showed sweat gland uptake in bilateral axilla. Liver false positive uptake was found in 253 cases. Conclusion The common sites of false positive 131 I uptake in DTC were gastrointestinal tract, lung and liver. False positive uptake in other sites is uncommon. A systematic approach to the interpretation of 131 I whole body scan is suggested in order to prevent unnecessary treatment with 131 I.