甲状腺切除术后应用甲状腺平面显像评估残余甲状腺:与治疗剂量131I扫描的对比

目的:我国常用^99mTc甲状腺扫描评估甲状腺癌术后残余甲状腺大小,本文拟对甲状腺扫描与治疗剂量的¹³¹I扫描进行比较分析。方法:148例（男51,女97）2年内就诊甲状腺癌术后病人入组,年龄（47.0±13.3）岁,2名核医学科医师独立、盲法阅片,采用5分法计分。统计学分析采用秩相关研究,相关系数采用t检验进一步比较。结果:69/148（46.6%）两种显像结果得分一致,79（53.4%）¹³¹I扫描得分高于甲扫。甲扫及¹³¹I扫描评分结果与甲状腺激素水平均相关（P<0.001）,且相关系数间甲扫与T₃、T₄相关程度更高（t₁=-1.933,P=0.028;t₂=-2.788,P=0.003）。结论:^99mTc甲状腺平面显像可作为术后残余甲状腺的评估方法,但¹³¹I扫描显示范围更大,两者与甲状腺激素水平均相关,但甲扫与其相关性可能更高。

Application of Thyroid Planar Imaging for Evaluating Residue Thyroid After Thyroidectomy: Compared with 131I Scan After Radioiodine Therapy

Objective In China,99mTc thyroid planar imaging was the most popular way to evaluate the residue thyroid after thyroidectomy. This study intended to observe the difference between99mTe thyroid scan and 131I scan after radioiodine therapy in thyroid cancer. Methods Total 148 histologic proven thyroid cancer patients in recent 2-year were collected into the study（51 male,97 female, age 47.0 ± 13.3y）. The images were respectively interpreted by 2 nuclear medicine doctors with a 5-point method, unknown the patients information. The data were analyzed by rank correlation and t test. Results 69/148 （46.6%） patients had the same score in two scan. But it was been up regulated in 131I scan in other 79（53.4% ） patients. Two scans had correlation with thyroid stimulating hormone （P 〈 0.001 ）. And 99mTc scan would be higher relationship than 131 whole-body scan in the level of blood triiodothyronine （T3 ） and thyroxine（ W4 ） （t1 = -1. 933, P = 0.028;t2 = -2.788, P = 0.003 ）. Conclusion 99mTc thyroid scan may be suitable for evaluating residue thyroid. Both of them had connection with the level of blood thyroid stimulating hormone, but 99mTc thyroid scan could more sensitive to show the change of the level of blood thyroid stimulating hormone compared with 131I scan.