第二眼超声诊断乳头状甲状腺癌131I治疗后颈部SPECT/CT异常摄碘灶性质

目的探讨第二眼超声诊断乳头状甲状腺癌131I治疗后颈部SPECT/CT显像中异常摄碘灶性质的价值。方法对41例颈部SPECT/CT中见异常摄碘灶的131I治疗后乳头状甲状腺癌患者行SPECT/CT引导下第二眼超声扫查,判断其良恶性,根据细针穿刺细胞学检查(FNAC)或随访结果进行确诊。结果对11例行FNAC:7例确诊为淋巴结转移,第二眼超声诊断其中6例为淋巴结转移、1例为良性,4例FNAC确诊为良性,第二眼超声均诊断为良性。对30例持续随访:8例第二眼超声诊断为正常淋巴结,其中6例随访诊断为良性,2例随访诊断为淋巴结转移;7例第二眼超声诊断为转移淋巴结,其中3例随访诊断为良性,4例随访诊断为复发或转移;15例第二眼超声未见病灶,随访诊断为良性。结论SPECT/CT引导下第二眼超声可提高诊断甲状腺癌131I治疗后淋巴结转移或复发的准确率。

Second-eye ultrasound in diagnosis of the iodine uptake lesions in SPECT/CT in thyroid cancer patients after 131I treatment

Objective To evaluate the value of the second-eye ultrasonography in diagnosis of the iodine uptake lesions in SPECT/CT in patients with thyroid carcinoma after ¹³¹I treatment. Methods Totally 41 thyroid carcinoma patients after ¹³¹I treatment with iodine uptake lesions in the neck in SPECT/CT underwent SPECT/CT guided second-eye ultrasound to diagnose the benign and malignant of the lesions. The nature of the lesions were confirmed by fine needle aspiration cytology (FNAC) and follow-up. Results There were 11 receiving FNAC. Among them, 7 were diagnosed as metastatic lymph nodes in which 6 were diagnosed as metastatic lymph nodes 1 was diagnosed as benign lesions by second-eye ultrasound, 4 were diagnosed as benign lesions which were all diagnosed by second-eye ultrasound correctly. There were 30 being seen for follow-up, among them 8 were shown as normal lymph node by second-eye ultrasound in which 6 were diagnosed as benign and 2 were diagnosed as metastasis or recurrence during follow-up, 7 were shown as metastasis in which 3 were diagnosed as benign and 4 were diagnosed as metastasis or recurrence during follow-up, 15 showed no lesions which were diagnosed as benign during follow-up. Conclusion SPECT/CT guided second-eye ultrasound can improve the diagnostic accuracy of metastatic or recurrence in thyroid carcinoma after ¹³¹I treatment.