| 夏 亮,陆涤宇,周 俊.131I-SPECT/CT多模态显像联合超声及血清Tg对分化型甲状腺癌颈部淋巴结转移的诊断价值[J].肿瘤学杂志,2017,23(4):278-281. |
| 131I-SPECT/CT多模态显像联合超声及血清Tg对分化型甲状腺癌颈部淋巴结转移的诊断价值 |
| 131I-SPECT/CT Fusion Imaging Combined with Ultrasonography and Serum Tg in Diagnosis of Lymph Node Metastasis in Patients with Differentiated Thyroid Cancer After 131I Treatment |
| 投稿时间：2016-11-01 |
| DOI：10.11735/j.issn.1671-170X.2017.04.B005 |
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| 中文关键词: 131I-SPECT/CT断层融合显像 131I全身显像 分化型甲状腺癌 放射性同位素 |
| 英文关键词:131I-SPECT/CT fusion imaging 131I whole body scan differentiated thyroid cancer radionuclide |
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| 中文摘要: |
| 摘 要：［目的］ 探讨SPECT/CT多模态显像联合颈部超声及血清甲状腺球蛋白（Tg）对分化型甲状腺癌(DTC)131I治疗后颈部淋巴结转移的诊断价值。［方法］ 68例DTC术后患者，131I治疗前行血清Tg 及颈部超声检查，131I治疗后5d分别行WBS及SPECT/CT多模态显像，联合颈部超声及Tg，以病理及随访结果为诊断标准，采用χ2检验对两种显像方法进行比较。［结果］ 68例DTC患者，颈部病灶共180个，SPECT/CT多模态显像检出率96.67%（174/180），WBS检出率90.56%（163/180，），差异有统计学意义（χ2=5.26，P=0.018）。单独联合超声或Tg，以及同时联合超声和Tg时，131I-SPECT/CT多模态显像对DTC术后颈部淋巴结转移灶的诊断价值与131I-WBS比较差异均有统计学意义（χ2=34.065，P＜0.001；χ2=38.246，P＜0.001；χ2=19.431，P＜0.001）。灵敏度、特异性及准确性方面，131I-SPECT/CT多模态显像联合超声分别为94.57%、94.31%、94.44%，131I-WBS联合超声分别为78.26%、60.23%、69.44%；131I-SPECT/CT多模态显像联合Tg分别为94.57%、92.05%、93.33%，131I-WBS联合Tg分别为64.13%、67.05%、65.56%；131I-SPECT/CT多模态显像联合超声及Tg分别为94.57%、97.73%、96.11%，131I-WBS联合超声及Tg分别为66.30%、93.18%、79.44%。［结论］ SPECT/CT多模态显像联合超声及血清Tg能提高DTC患者131I治疗后颈部淋巴结转移病灶的检出率，明显提高颈部淋巴结转移诊断的灵敏度、特异性及准确性。 |
| 英文摘要: |
| Abstract：［Objective］ To evaluate the application of 131I -SPECT/CT fusion imaging combined with ultrasonography(US) and serum thyroglobulin(Tg) in diagnosis of cervical lymph node metastasis in patients with differentiated thyroid cancer(DTC) after 131I treatment. ［Methods］ Sixty eight patients with DTC underwent ultrasonography examination and serum Tg was measured before 131I treatment. 131I-whole body scan(WBS) and 131I-SPECT/CT fusion imaging were performed 5 days after 131I treatment. Pathological and follow-up results were used as diagnostic standard. χ2 test was used to compare the two imaging methods. ［Results］ There were 180 foci of the neck in 68 patients，174 were detected by SPECT/CT fusion imaging(174/180，96.67%)，and 163 were detected by WBS(163/180，90.56%)(χ2=5.26，P=0.018). There were significant differences in diagnostic rate of cervical foci by combination of SPECT/CT fusion imaging with US，Tg or both，compared to by WBS(χ2=34.065，P＜0.001；χ2=38.246，P＜0.001；χ2=19.431，P＜0.001). The sensitivity，specificity and accuracy of 131I-SPECT/CT fusion imaging combined with US in detection of cervical foci were 94.57%，94.31%，94.44%，those of 131I-WBS combined with US were 78.26%，60.23%，69.44%；those of 131I-SPECT/CT fusion imaging combined with Tg were 94.57%，92.05%，93.33%，those of 131I-WBS combined with Tg were 64.13%，67.05%，65.56%；those of 131I-SPECT/CT fusion imaging combined with US and Tag were 94.57%，97.73%，96.11%，those of 131I-WBS combined with both two were 66.30%，93.18%，79.44%. ［Conclusions］ SPECT/CT fusion imaging combined with both US and Tg can improve the diagnostic accuracy of cervical foci for DTC patients after 131I treatment. |
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