SPECT/CT融合显像对分化型甲状腺癌术后颈部转移淋巴结的诊断价值

目的探讨131I单光子发射型计算机断层显像-计算机断层摄影(131I-SPECT/CT)同机融合显像与甲状腺球蛋白(Tg)、B超对分化型甲状腺癌(DTC)病人术后颈部淋巴结转移灶的诊断价值。方法对30例术后DTC颈部淋巴结转移的病人,口服2.96~7.40 GBq剂量131I后7 d,分别行131I全身扫描、SPECT颈部断层与同机CT图像融合,将131I-SPECT/CT结果与Tg、B超检查结果进行比较。结果 30例DTC病人中,22例(70.3%)血清Tg阳性,8例阴性;131I-SPECT/CT检查颈部淋巴结转移阳性26例(86.7%),4例阴性;B超检查颈部淋巴结转移阳性14例(46.7%),16例阴性。共56个颈部淋巴结转移,131I-SPECT/CT颈部融合显像发现淋巴结转移灶50个(89.20%);B超检查发现淋巴结转移灶39个(69.6%)。131I-SPECT/CT与Tg检测DTC颈部淋巴结转移阳性率比较,差异无显著性(2χ=1.13,P>0.05)。131I-SPECT/CT与B超对颈部淋巴结转移的检出率比较,差异有显著性(χ2=6.86,P<0.01)。结论 131I-SPECT/CT融合显像和Tg对监测DTC术后病人淋巴结转移的临床价值高,二者相互补充。131I-SPECT/CT融合显像对颈部淋巴结转移诊断价值高于B超。

THE VALUE OF 131I-SPECT/CT FUSION IMAGING IN THE DIAGNOSIS OF CERVICAL LYMPH NODE METASTASIS OF DIF- FERENTIATED THYROID CARCINOMA

Objective To assess the value of 131I-SPECT/CT fusion image,Tg and ultrasonography in the diagnosis of post-operative cervical lymph node metastasis(CLNM) in patients with differentiated thyroid carcinoma(DTC).Methods 131I whole body scanning and 131I-SPECT/CT fusion imaging were preformed on 30 DTC patients with post-operative CLNM 7 days after taking 131I(2.96-7.4 GBq) orally,the results were compared with Tg and the findings of ultrasonography.Results Of the 30 patients,positive Tg was found in 22 cases(70.3%);CLNM was detected by SPECT/CT in 26 patients(86.7%) and 14(46.7%) by ultrasonography.A total of 56 metastatic lymph nodes were confirmed,of which 50(89.20%) found by SPECT/CT images and 39(69.6%) by ultrasonography.There was no difference between 131I-SPECT/CT fusion imaging and Tg in detecting POCLNM(χ2=1.13,P>0.05),but the difference between 131I-SPECT/CT imaging and ultrasonography was significant(χ2=6.86,P<0.01).Conclusion 131I-SPECT/CT fusion imaging and Tg are sensitive for monitoring post-operative CLNM in DTC patients,and 131I-SPECT/CT fusion imaging is better than ultrasonography in detecting CLNM.