18F-FDG符合线路显像与131I-SPECT/CT探测甲状腺乳头状癌术后转移的价值

目的：评价甲状腺乳头状癌术后18F-FDG符合线路显像与131I-SPECT/CT对转移灶的诊断价值。方法：经过甲状腺手术及131I成功清除甲状腺残留组织的56例甲状腺乳头状癌患者，在第2次131I治疗前1周内行18F-FDG符合线路显像，并在给予剂量3.7~7.4GBq 131I后第3天行131I-SPECT/CT，对比分析两种显像结果，并统计分析影响18F-FDG符合线路显像探测效率的因素。结果：131I-SPECT/CT诊断甲状腺乳头状癌术后转移患者的灵敏度、特异性、准确性、阳性预测值、阴性预测值分别为84.21%（32/38），94.44%（17/18），87.5%（49/56），96.97%（32/33），73.91%（17/23）。131I-SPECT/CT诊断甲状腺乳头状癌术后转移患者的灵敏度、准确性、阴性预测值高于18F-FDG符合线路显像（χ2=16.114，14.175，6.285，P均<0.05）。18F-FDG符合线路显像阳性组与阴性组的转移病灶大小分别为（1.83±0.30）cm、（1.29±0.26）cm，差异有统计学意义（P<0.001）。结论：131I-SPECT/CT诊断甲状腺乳头状癌术后转移患者的灵敏度、准确性、阴性预测值高于18F-FDG符合线路显像；18F-FDG符合线路显像是131I-SPECT/CT在甲状腺乳头状癌转移诊断中的重要补充，其探测效率与转移灶大小有关。

Clinical value of ~(18)F-FDG dual head coincidence imaging and ~(131)I-SPECT/CT in the diagnosis of patients with metastatic after resection of papillary thyroid carcinoma

Objective： The aim of this study was to evaluate the value of 18F-FDG dual head coincidence imaging and 131I-SPECT/CT in the diagnosis of patients with metastatic papillary thyroid carcinoma（PTC）.Methods： Fifty-six patients who had thyroidectomy and radioiodine ablation of residual normal thyroid tissue were included.They all had 18F-FDG dual head coincidence imaging and 3 days after giving 3.7～7.4GBq 131I 131I-SPECT/CT were performed.We had comparative analysis of the two imaging results and the variable parameters between the 18F-FDG dual head coincidence imaging positive group and 18F-FDG dual head coincidence imaging negative group.Results： The sensitivity,specificity,accuracy,positive predictive value and negative predictive value were 84.21%（32/38）,94.44%（17/18）,87.5%（49/56）,96.97%（32/33）,73.91%（17/23）.The difference was significant between 131I-SPECT/CT and 18F-FDG dual head coincidence imaging in sensitivity,accuracy,negative predictive value（χ2=16.114,14.175,6.285,all P0.05）.Metastatic size of 18F-FDG dual head coincidence imaging positive group and negative group were（1.83±0.30）cm,（1.29±0.26）cm,respectively,the difference between them was statistically significant（P0.001）.Conclusion： 131I-SPECT/CT was likely to disclose more metastasis than 18F-FDG dual head coincidence imaging in patients with PTC.18F-FDG dual head coincidence imaging is an important supplement of 131I-SPECT/CT in detecting metastatic PTC,the metastatic size affected the sensitivity of 18F-FDG dual head coincidence imaging.