【摘要】 目的评价¹³¹I SPECT/CT判断DTC患者清甲治疗时甲状舌管的存在情况及其对¹³¹I治疗的影响。方法回顾性分析127例以¹³¹I清甲为目的 DTC术后患者,男29例,女98例,平均年龄39. 7±12. 8岁,¹³¹I治疗前停用左甲状腺素钠3周以上,测得刺激后血清TSH、Tg和TgAb水平,完成颈部⁹⁹Tc^mO₄^-显像,治疗剂量为（384. 0±64. 3）×10⁷Bq（103. 90±17. 37mCi）。服¹³¹I后72～96小时内完成颈胸部SPECT/CT融合显像。结果 127例患者中,SPECT/CT显示有甲状舌管残留58例,无甲状舌管残留69例。有或无甲状舌管残留人群的刺激后Tg分别为5.31 pmol/L(3.05～14.26 pmol/L和3.58pmol/L（2.15～7.10 pmol/L）,¹³¹I治疗剂量分别为（389.0±64.3）×10⁷Bq（105.17±17.37 mCi）和（381.2±64.8）×10⁷Bq（102. 90±17. 51 mCi）。有或无甲状舌管残留人群在年龄、性别、病理类型、刺激后Tg-Ab和¹³¹I治疗剂量等方面均无明显差异,但前者的刺激后Tg要明显高于后者（Z=2.435,P=0.015）。^99mTcO4^-显像示甲状舌管残留者42例,无甲状舌管残留者85例;以SPECT/CT结果为诊断标准,则⁹⁹Tc^mO₄^-显像诊断甲状舌管的敏感性、特异性和准确性分别为67. 2%、95.7%和82. 7%。结论甲状舌管残留在DTC术后接受¹³¹I清甲治疗的人群中较常见,¹³¹I SPECT/CT显像有助于判断甲状舌管的残留情况、指导诊疗策略的正确制定。更多还原

【Abstract】 Objective To investigate the clinical value of thyroglossal tract thyroid tissue using SPECT/CT fusion imaging in DTC patients. Methods 127 patients（29 males and 98 females） underwent the first ¹³¹I ablation were included in our study. The average age of patients was 39.7 ± 12. 8. All patients were prepared with thyroid hormone withdrawal for at least three weeks and measured the levels of serum TSH,Tg and TgAb. These patients underwent 99 Tcm0₄^-neck planar imaging. 72-96 hours after the oral therapeutic 131 I,and131 I dose was（384. 0 ± 64. 3） x 10⁷ Bq（103. 90 ± 17. 37 mCi）. All patients undertook 131 I SPECT/CT regional fusion imaging. Results Of all 127 patients,thyroglossal tract thyroid tissue was present on the images of SPECT/CT fusion imaging for 58 patients. 69 patients did not have thyroglossal tract on SPECT/CT.Based on the results of SPECT/CT, the stimulated serum Tg of patients with or without thyroglossal tract were 5.31 pmol/L（3.05-14. 26 pmol/L） and 3.58 pmol/L（2.15-7.10 pmol/L）. The doses of ¹³¹I were（389.0 ±64.3） ×10⁷ Bq（105. 17 ± 17. 37 mCi） and（381. 0 ±64. 8） x 10⁷ Bq（102. 90 ± 17. 51 mCi）.There weren’ t significant differences of age, gender, pathology and stimulated TgAb and dose of ¹³¹I,however,the level of stimulated Tg was higher in patients with thyroglossal tract than that of the patients without thyroglossal tract. According to the results of SPECT/CT, the sensitivity, specificity and accuracy of99 Tcm04-imaging were 67.2% 、95. 7% and 82. 7%, respectively. Conclusion Thyroglossal tract thyroid tissue is present in nearly one half of our study population.¹³¹I regional SPECT/CT fusion imaging can provide valuable information to evaluate the present of thyroglossal tract and guide the treatment.更多还原