99mTc-奥曲肽SPECT/CT对活动期甲状腺相关性眼病治疗的效果评价

目的 探讨99mTc-奥曲肽眼眶SPECT/CT显像对活动期甲状腺相关性眼病（TAO）治疗效果评价的价值。设计 回顾性病例系列。研究对象 21例活动期TAO患者，37眼受累，5眼未受累。方法 对活动期TAO治疗前后分别行99mTc-奥曲肽眼眶SPECT/CT显像及临床活动性评分（CAS），以评价治疗效果。主要指标 眼眶与枕部颅骨的示踪剂摄取比值（O/OCC）、受累眼外肌组数（N）、临床活动性评分CAS。结果 治疗前受累眼肌数N为（2.70±1.00）条，CAS为（5.49±2.04）。治疗前受累眼的O/OCC为（2.00±0.35），高于未受累眼的（1.14±0.10），差异有统计学意义（P=0.000）。治疗后受累眼O/OCC为（1.38±0.30）、CAS为（1.78±1.18）、N为（1.16±0.93），均低于治疗前（P均=0.000）。而未受累眼治疗后O/OCC为（1.03±0.07），与治疗前比较无统计学差异（P=0.242）。治疗前O/OCC、N与治疗前CAS有中度相关性（r=0.574，P<0.01；r=0.445，P<0.01）；治疗后O/OCC与治疗后CAS有中度相关性（r=0.555，P<0.01），而治疗后N与治疗后CAS无相关性（r=0.235，P>0.01）。结论　99mTc-奥曲肽眼眶SPECT/CT显像在评价活动期TAO治疗效果上具有较好的应用价值。（眼科，2013, 22： 309-312）

The evaluation of treatment effect of active thyroid associated ophthalmopathy with 99mTc labeled octreotide SPECT/CT

Objective To explore the application of orbital 99mTc labeled octreotide SPECT/CT on the treatment effect evaluation of active thyroid associated ophthalmopathy(TAO). Design Retrospetive case series. Participants Twenty-one patients with active TAO were observed, with 37 afflicted eyes and 5 normal eyes. Methods Orbital 99mTc labeled octreotide SPECT/ CT and the clinical activity score (CAS) were separately performed before and after treatments in the patients with TAO. Main Outcome Measures An uptake ratio between the orbits and the occipital skull（O/OCC）, the numbers of involved extraocular muscles（N） and CAS. Results Before treatment,the average of N was 2.70±1.00 and its CAS was (5.49±2.04). Before treatments, the O/OCC of afflicted eyes(2.00±0.35) were higher than that in normal eyes(1.14±0.10)(P=0.000). After treatments, the O/OCC, CAS and N were (1.38±0.30), (1.78±1.18), (1.16±0.93) on average, respectively and significantly reduced compared to those before treatment in afflicted eyes（all P=0.000）. There was no statistical differences in normal eyes before and after treatments in the O/OCC(1.03±0.07) (P=0.242). A statistically significant correlation was found in the O/OCC versus CAS before and after treatments (r=0.574，P<0.01; r=0.555，P<0.01). A statistically significant correlation was also found in N versus CAS before treatments (r=0.445，P<0.01), but not found after treatments (r=0.235，P>0.01). Conclusion Orbital ^99mTc labeled octreotide SPECT/ CT is with good prospect in evaluating treatment effect of active TAO. (Ophthalmol CHN, 2013, 22: 309-312)