分化型甲状腺癌术后^99Tc^m—MIBI显像与^131 I显像比较及其意义 |
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引用本文: | 邱李恒,林岩松,龙明清,巴建涛,王正华,马艳茹,牛娜,刘轶敏,李方.分化型甲状腺癌术后^99Tc^m—MIBI显像与^131 I显像比较及其意义[J].齐鲁肿瘤杂志,2011(18):1482-1486. |
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作者姓名: | 邱李恒 林岩松 龙明清 巴建涛 王正华 马艳茹 牛娜 刘轶敏 李方 |
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作者单位: | 中国医学科学院北京协和医院核医学科,北京100730 |
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摘 要: | 目的:探讨分化型甲状腺癌(DTC)术后^99Tc^m—MIBI显像结果的意义。方法:300例DTC术后患者中随机选取69例行^99Tc^m-MIBI显像。2名有经验核医学医师盲法阅片。将^99Tc^mMIBI显像结果与治疗后^131I显像结果比较。另对经高分辨CT或治疗后^131 I显像诊断肺转移和无肺转移患者行半定量分析,比较靶本底比值(T/B)。结果:排除1例死于血管肉瘤者,余按照手术方式及^131 I治疗情况分为3组(A组:44例甲状腺癌术后拟^131I治疗组;B组:22例有再次^131I治疗指征组;C组:2例甲状腺大部切除组)。A组^99 Tc^m-MIBI显示残余甲状腺34.1%(15/44),转移灶30.0%(6/20)。B组^9^Tc ^m-MIBI显示复发及转移灶63.6%(7/11)。C组^99Tc^mMI—BI显示残余甲状腺100.0%(2/2),并为唯一一种发现颈部转移显像方法。5例患者同时存在多种性质转移灶:MI—BI+I-,MIBI-I+及MIBI+I+。肺转移与无肺转移患者T/B比值差异无统计学意义。结论:^99Tc^m -MIBI可发现分化好及失分化病灶,联合^131 I显像为DTC术后患者选择治疗方式提供重要信息,有临床应用价值。
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关 键 词: | 甲状腺肿瘤 ^99m锝甲氧基异丁基异腈 放射性核素显像 |
Research on application of ^99Tcm-MIBI scan compared with ^131I whole-body scan to the postsurgical patients with DTC |
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Authors: | QIU Li-heng LIN Yan-song LONG Ming- qing BA Jian tao WANG Zheng-hua MA Yan-ru NIU Na LIU Yi-min LI Fang |
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Institution: | (Department of Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, P.R. China) |
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Abstract: | OBJECTIVE: To evaluate the clinical utility of ^99Tc^m MIBI scintigraphy in the postsurgical patients with differentiated thyroid cancer (DTC). METHODS: A prospective study of 69 patients randomized picked out from 300 DTC patients underwent ^99Tc^m -MIBI scan after thyroidectomy. Visual analysis of the scintigraphic images was performed by two experienced physicians without clinical findings and results of the other imaging. The result compared with posttherapy ^131I scan. In addition, ^99 Tc^m-MIBI uptake in lung was semi-quantitatively evaluated by calculating the target-to background (T/B) ratio. RESULTS: One patient who died of angiosarcoma was excluded. According to radioiodine therapy and surgery style, the patients were categorized into 3 groups for analysis. Group A (n= 44): prepare for initial ^131 I treatment after thyroidectomy. Group B (n =22): need further ^131I treatment. Group C (n= 2) : underwent partial thyroidectomy alone. In group A, ^99Tc^m-MIBI scans detected thyroid remnants in 15 of 44 pa tients (34. 1%) and metastatic loci in 6 of 20 (30.0%) patients. In group B, ^99 Tc^m-MIBI scans detected recurrent and metastatic loci in 7 of 11 (63.6%). In group C, ^99Tc^m- MIBI scan detected all the remnants (2/2,100.0%), and to be the only examination detecting a cervical lymph node metastasis in one patient. Five patients had three type metastases: MIBI+1-, MIBI-I+ and MIBI+I- metastases. T/B ratio showed no significant difference between non-metastatic and metastatic groups in lung which confirmed by high-resolution CT or posttherapy ^131I scan. CONCLUSIONS: ^99Tc^m-MIBI can reveal both functioning and non-functioning metastases, so ^99 Tc^m MIBI scan may be useful for choosing the best therapeutic approach. The combination of ^99Tc^m-MIBI with ^131 I offers the highest diagnostic yield. |
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Keywords: | thyroid neoplasms ^99 Tc^m-MIBI radionuclide imaging |
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