【摘要】 目的探讨¹³¹Ⅰ治疗后行全身显像（Rx-WBS）及SPECT/CT融合显像的甲状腺微小乳头状癌（PTMC）的病例特点,为指导临床治疗提供借鉴。方法回顾性分析2015年1月至2019年12月在宜昌市中心人民医院进行¹³¹Ⅰ清甲治疗的145例PTMC术后患者的临床资料。所有患者均在口服¹³¹Ⅰ后2～10 d行Rx-WBS及SPECT/CT融合显像,根据显像结果分为残留甲状腺伴转移组（残甲伴转移组）21例和仅有残留甲状腺组织组（单纯残甲组）124例。分别比较两组患者的性别、年龄、手术方式、¹³¹Ⅰ治疗前刺激性甲状腺球蛋白（ps-Tg）、甲状腺球蛋白抗体（TgAb）、肿瘤病理特点（肿瘤最大直径、腺叶累及、多灶性、包膜外侵犯、淋巴结转移）。结果残甲伴转移组多为男性,与单纯残甲组比较,有更高的ps-Tg水平及更多的淋巴结转移数,而两组在年龄、手术方式、血清TgAb水平、肿瘤最大直径、腺叶受累情况、多灶性、甲状腺包膜外侵犯方面,差异无统计学意义（均P>0.05）。结论男性、高ps-Tg水平及高淋巴结转移数与PTMC ¹³¹Ⅰ Rx-WBS及SPECT/CT融合显像发现转移灶相关,建议此类患者术后积极行¹³¹Ⅰ治疗。更多还原

【Abstract】 Objective To investigate the whole body scan（Rx-WBS）and SPECT/CT fusion imaging characterists of papillary thyroid microcarcinoma（PTMC）after ¹³¹Ⅰ treatment, and to provide some useful references for guiding clinical treatment.Methods The clinical data of 145 patients after PTMC who underwent ¹³¹Ⅰ treatment in our department from January 2015 to December 2019 were retrospectively analyzed.All patients underwent Rx-WBS and SPECT/CT fusion imaging 2-10 days after oral ¹³¹Ⅰ.According to the imaging results, the patients were divided into two groups: the group with residual thyroid with metastasis（21 cases）and the group with residual thyroid tissue（124 cases）.Gender, age, surgical approach, preablative stimulated thyroglobulin（ps-Tg）,thyroglobulin antibody（TgAb）and tumor pathological characteristics（maximum tumor diameter, glandular involvement, multifocal, extrathyroid capsule invasion and lymph node metastasis）were compared between the two groups of patients, respectively.Results The residual thyroid with metastasis group was mostly male, compared with the residual thyroid group, and there were higher ps-Tg levels and more lymph node metastases.There was no statistically significant difference between the two groups in the age of onset, the surgical approach, the serum TgAb level, the maximum tumor diameter, the involvement of the glandular lobe, multifocal, extrathyroid capsule invasion and lymph node metastasis（all P>0.05）.Conclusion Male, high ps-Tg level and high lymph node metastasis are related to metastases found on PTMC ¹³¹Ⅰ Rx-WBS and SPECT/CT fusion imaging.It is recommended that these patients be actively treated with ¹³¹Ⅰ after surgery.更多还原