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清甲剂量131I在分化型甲状腺癌转移灶诊断中的临床价值

于鹏,宫凤玲   

  1. 华北煤炭医学院附属医院
  • 收稿日期:2011-02-12 修回日期:2011-04-27 出版日期:2012-02-15 发布日期:2012-02-15
  • 通讯作者: 于鹏

Clininal use of 131I of thyroidectomy dose in the metastases of the differentiated thyroid carcinoma

  • Received:2011-02-12 Revised:2011-04-27 Published:2012-02-15 Online:2012-02-15
  • Contact: Peng YU

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摘要： 摘要:目的:在施行部分甲状腺切除的分化型甲状腺癌病人中，评价清甲剂量131I（3.7GBq）在诊断甲状腺癌转移灶中的临床价值。方法： 23例怀疑转移的分化型甲状腺癌病人，其中乳头状癌17例，滤泡型癌6例，均进行了甲状腺大部分切除术，术后时间为4个月至35个月。测定患者血清中的Tg（甲状腺球蛋白）值，行重点部位的B超或CT检查，进行诊断剂量的甲状腺131I全身及局部扫描，然后给与患者清甲剂量的131I（3.7GBq）治疗，服药一周后再次进行131I全身扫描，将结果与诊断剂量的扫描结果进行比较。结果：在23例病人中，20例伴有不同程度的Tg升高，3例结果正常；B超提示甲状腺癌局部复发4例；CT提示发现远处转移灶15例，转移部位分别为颈部淋巴结、双肺、骨骼及脑。诊断剂量131I全身显像发现5例病人出现异常131I摄取，其中颈部淋巴结摄取4例，双肺摄取3例；而清甲剂量的131I发现21例病人有异常的131I摄取，其中，颈部及纵隔淋巴结16例，双肺8例，骨骼摄取5例，脑组织摄取2例。结论：清甲剂量的131I全身显像在发现分化型甲状腺癌术后转移病灶的阳性率明显高于诊断剂量的131I全身显像。 关键词：甲状腺清除；131I；分化；甲状腺癌；转移

关键词: 甲状腺清除, 131I, 分化, 甲状腺癌, 转移

Abstract: 【Abstract】Objective: To evaluate the clinical value of 131I of thyroidectomy dose in the metastases of the differentiated thyroid carcinoma patients who were cut off most part of thyroid. Method: Twenty three differentiated thyroid carcinoma patients who were suspected metastases, including 17 cases of papillary cancer, 6 cases of follicular cancer , all were cut off most part of thyroid before 4 months to 35 months, measured the thyroglobulin levels in the blood serum, took ultrasound or CT check, took 131I- WBS using diagnostic dose, then gave patients 131I of thyroidectomy dose, took 131I- WBS again after one week, compared the results with the previous results. Result: 23 cases of patients, with thyroglobulin levels arising in 20 cases, ultrasound found recurrence in 4 cases, CT found metastases in 15 cases, including lymph node of neck, lungs, skeletons and brain. 131I- WBS of diagnostic dose found abnormal uptakes in 5 cases of patients, including 4 positions in lymph node of neck,3 positions in the lungs, while, 131I- WBS of thyroidectomy dose found abnormal uptakes in 21 cases of patients, including 16 positions in lymph node of neck and mediastina, 8 positions in lungs, 5 positions in skeletons and 2 positions in brain.,Conclusion: The positive rates of 131I- WBS of thyroidectomy dose in differentiated thyroid carcinoma is obviously superior to that of diagnostic dose. 【Key words】thyroidectomy; 131-iodine; differentiated； thyroid carcinoma；metastases

Key words: thyroidectomy, 131-iodine, differentiated, thyroid carcinoma, metastases