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目的评价131I-单光子发射计算机断层显像(single photon emissioncomputed tomog-raphy,SPECT)/CT融合显像鉴别诊断分化型甲状腺癌(differentiated thyroid cancer,DTC)患者转移灶的临床应用价值。方法 69例经131I治疗后的DTC患者,对131I治疗剂量全身显像(131I-whole body scan,131I-WBS)的135处放射性摄取增高灶行131I-SPECT/CT同机融合显像,对两种检查结果进行对比。最终临床诊断以病理、6个月以上的临床随访、其他影像学检查结果为依据。结果 69例131I-WBS的135处放射性摄取增高灶,经131I-SPECT/CT融合显像后均明确定位。排除了21处假阴性病灶和9处假阳性病灶1。31I-SPECT/CT融合显像鉴别转移灶优于131I-WBS(χ2=4.03,P<0.05)1。31I-WBS和131I-SPECT/CT融合显像诊断DTC转移灶的敏感性分别为70.79%,94.38%;特异性分别为76.09%,95.65%。结论 131I-SPECT/CT融合显像能更好的对放射性摄取增高灶进行精确定位和定性,是鉴别诊断DTC患者转移灶的一种较好检查方法,在临床应用中有重要价值。
Objective To evaluate the clinical value of single photon emission computed tomography (CT) / CT fusion in the differential diagnosis of metastatic lesions in patients with differentiated thyroid cancer (DTC). Methods Sixty-nine patients with DTC treated with 131I had 131I-SPECT / CT fusion imaging on 131I-whole body scan (131I-WBS) at 135 radioimmunoassay, Kind of inspection results for comparison. The final clinical diagnosis with pathology, more than 6 months of clinical follow-up, the results of other imaging studies as the basis. Results The radioactivity uptake of 131 cases of 131I-WBS was increased in all 131 cases. All of them were clearly localized after 131I-SPECT / CT fusion imaging. Exclusion of 21 false negative lesions and 9 false positive lesions by 1.31I-SPECT / CT fusion imaging was superior to 131I-WBS (χ2 = 4.03, P <0.05) in 1.31I-WBS and 131I-SPECT / The sensitivity of CT fusion imaging in diagnosis of DTC metastasis was 70.79% and 94.38% respectively; the specificity was 76.09% and 95.65% respectively. Conclusions 131I-SPECT / CT fusion imaging can better locate and characterize the higher radioactive uptake of foci, which is a better method for differential diagnosis of metastasis in patients with DTC. It has important value in clinical application.