【摘要】 目的:探讨131I全身扫描(131I-WBS)、99Tcm-MIBI全身扫描(99Tcm-MIBI-WBS)及血清甲状腺球蛋白(Tg)监测对分化型甲状腺癌(DTC)复发或转移灶检测的临床价值。方法:回顾142例131I治疗DTC患者影像学资料,分析该病131I-WBS及99Tcm-MIBIWBS影像学特征及临床价值,并分析实验室血清测定结果。结果:131I-WBS对DTC转移灶的敏感度为85.1%,特异度为84.2%,阳性预测率为72.7%,阴性预测率为92%;99Tcm-MIBI-WBS对DTC转移灶的敏感度为80%,特异度为95.5%,阳性预测率为88.9%,阴性预测率为91.3%。两项检查联合对DTC转移灶的敏感度为100%,特异度为86.4%,阳性预测率为76.9%,阴性预测率为100%。血清Tg水平测定对判定DTC是否存在转移灶具有指示意义。结论:131I-WBS与99Tcm-MIBI-WBS联合应用可以弥补单一种类显像的不足,提高转移灶的检出率。血清Tg测定结果可以用于评价DTC术后患者是否存在转移灶。更多还原

【Abstract】 Objective: To explore features of 131I-WBS and 99Tcm-MIBI-WBS of the post- therapeutic differentiated thyroid carcinoma(DTC), and to discover the relationship between the results of the laboratory tests and DTC metastases for early detection of clinical of DTC metastases. Methods:131I-WBS of 142 cases receiving more than two 131I therapies and99Tcm-MIBI-WBS of 32 cases were analyzed.Features of 131I-WBS and 99Tcm-MIBI-WBS and results of laboratory serum determinations were summarized. Results: The sensitivity of detection for131I-WBS was 85.1%, for 99Tcm-MIBI-WBS 80%, and for combined imaging 100%. The specificity for 131I-WBS was 84.2%, for 99Tcm-MIBI-WBS 95.5%, and for combined imaging 86.4%. The positive predictive value(PPV) for 131I-WBS was 72.7%, for99Tcm-MIBIWBS 88.9%, and for combined imaging 76.9%. The negative predictive value(NPV) for 131I-WBS was 92%, for 99Tcm-MIBI-WBS 91.3%, and for combined imaging 100%. Serum thyroglobulin determinations could be used to diagnose DTC metastases. Conclusion: Combined 131 IWBS and 99Tcm-MIBI-WBS are superior to any mono-imaging method, and it can enhance the diagnosis rate of DTC metastases. Results of serum Tg determination could evaluate DTC metastase conditions, which may influence the result of 131I-WBS.更多还原