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目的 评价治疗剂量1 31 I全身显像在分化型甲状腺癌 (简称甲癌 )患者临床随访中的价值。方法 5 7例分化型甲癌患者在给予 185MBq(诊断剂量 ) 1 31 I 2～ 3d后进行前、后位全身显像 ;给予治疗剂量1 31 I7～ 10d后 ,用相同的采集条件进行全身显像 ,同时分析所有患者的血清甲状腺球蛋白水平。用配对 χ2 检验对结果进行处理。结果 31例接受1 31 I去除术后残留甲状腺组织患者 ,治疗剂量1 31 I显像与诊断剂量1 31 I显像结果一致的有 2 8例 ,前者发现新病灶 3例 ;接受转移灶治疗的 2 6例患者 ,治疗剂量1 31 I显像发现的转移灶较诊断剂量1 31 I显像发现多的有 9例 (34 % ) ,但无 1例后者较前者多 ,2种方法显像结果差异有显著性 (P <0 0 1)。各种因素与显像结果回归分析表明 ,手术中发现肿瘤体积大小以及病理类型与 2种方法显像结果差异有关。结论 治疗剂量1 31 I全身显像较诊断剂量1 31 I全身显像更易发现病灶 ,故前者有利于分化型甲癌患者随访及诊疗计划的安排。在甲癌患者接受1 31 I治疗后 7～ 10d应常规行全身显像。
Objective To evaluate the value of therapeutic dose 131I whole body imaging in the clinical follow-up of patients with differentiated thyroid carcinoma (abbr. CA). Methods Fifty-seven patients with differentiated type A cancer were treated with 185 MBq (diagnostic dose) 1 31 I 2 ~ 3 days before and after the whole body imaging. After the treatment dose of 31 I 7 ~ 10 days, the same conditions were used for whole body imaging. For example, serum thyroglobulin levels were analyzed in all patients at the same time. The results are processed using the paired χ2 test. Results Thirty-one patients with residual thyroid tissue after 131I removal were treated with 31 I imaging with diagnostic doses. 31 I imaging results were consistent with 28 cases. The former found 3 cases of new lesions; Of the 26 patients, 91% (34%) of the metastases detected by 31I imaging of the treatment dose were found more often than the diagnostic dose of 31I imaging, but none of the latter was more than the former and 2 methods were used for imaging. There was a significant difference in the results (P < 0 01). Regression analysis of various factors and imaging results showed that the size of the tumor and the pathological type found during surgery were related to differences in the results of the two methods. Conclusions The therapeutic dose of 131I whole body imaging is more likely to find the lesion than the diagnostic dose of 31I whole body imaging. Therefore, the former is beneficial to the follow-up of the patients with differentiated type A cancer and the arrangement of the diagnosis and treatment plan. Routine whole-body imaging should be performed 7 to 10 days after treatment of patients with oncogenic cancer.