131^I-SPECT／CT与131^I—WBI对分化型甲状腺癌转移灶的诊断价值比较

目的 探讨131^I-单光子发射型计算机断层显像-计算机断层摄影（131^I-SPECT／CT）同机融合显像与131^I-全身显像（131^I-WBI）对分化型甲状腺癌（DTC）病人术后头颈部及纵隔部转移灶的诊断价值。方法 对30例术后DTC头颈部及纵隔部转移的病人，口服131^I 185～370MBq诊断剂量后24～48h，分别进行131^I-WBI和131^I—SPECT／CT同机融合显像，显像结束后将二者检查结果进行回顾性分析并加以比较。结果 131^I-SPECT／CT融合显像检查发现DTC转移灶106处，占93．0％（106／114），有8处转移灶显示为阴性，占7．0％（8／114），无假阳性病灶。131^I-WBI检查发现DTC转移灶93处，占81．6％（93／114），有21处DTC转移灶显示为阴性，占18．4％（21／114），有13处假阳性转移灶。两种结果比较，差别有显著性（Х^2=6．68，P〈0．01）。结论 131^I-SPECT／CT融合显像能较准确检出、定位DTC转移灶和除外假阳性结果，更有益于DTC病人术后头颈及纵隔部转移灶的诊断和鉴别诊断。

COMPARISON OF THE 131^I-SPECT/CT FUSION IMAGES AND 131^I-WBI IN DETECTING THE METASTASES OF DIFFERENTIATED THYROID CARCINOMA

Objective To compare the diagnostic value of 131^I-SPECT/CT fusion images and 131^I-WBI in detecting the metastases of differentiated thyroid carcinoma （DTC） of the regions of the head, neck and mediastinum. Methods 131^I-SPECT/ CT fusion images and 131^I-WBI were taken for 30 patients with DTC confirmed surgically, 24-48h after taking a diagnostic dose of 131^I 185-370 MBq. A retrospective analysis and comparison of diagnostic value of the techniques were carried out. Results For 131^I-SPECT/CT fusion imaging, 106 metastatic lesions were detected among the total of 114 （93. 0%）, while eight of them were failed to be visualized （7.0%）, No false positive result was found; for 131^I-WBI, 93 （81.6%） metastatic lesions were identified, 21 were not visualized （18.4 %） with 13 false positive loci. 131^I-SPECT/CT confirmed more metastatic lesions than 131^I-WBI did （Х^2 = 6.68,P〈0.01）. Conclusion 131^I-SPECT/CT fusion imaging is a better method than 131^I-WBI in detection of the metastatic lesions of differentiated thyroid carcinoma.