论文部分内容阅读
目的分析大剂量~(131)I治疗分化型甲状腺癌肺内转移灶的影像学特征、临床疗效及其影响因素。方法应用大剂量~(131)I治疗分化型甲状腺癌患者156例,其中肺内出现转移灶12例(均已行甲状腺次全或全切除术及颈部淋巴结清扫)。~(131)I的单次使用剂量2.22～7.4GBq,总剂量7.4GBq～33.3GBq。随访持续时间至少一年。疗效判定:胸部X光及/或CT检查、~(131)I显像、血清甲状腺球蛋白和甲状腺球蛋白抗体水平测定,但主要为~(131)I显像。结果12例患者中11例在治疗后~(131)I显像发现肺内转移灶,其中9例在第1次治疗后显示肺内~(131)I摄取,2例在第2次治疗后显示肺内~(131)I摄取,另有1例患者治疗后肺内转移灶未显示有~(131)I摄取。11例显示肺内~(131)I摄取的患者中,6例X光胸片或CT检查未发现异常。所有患者大剂量~(131)I治疗后均有不同程度的好转,多次治疗后~(131)I显像示肺内~(131)I摄取逐渐降低,3例在治疗后最终显示正常。结论~(131)I是治疗分化型甲状腺癌肺内转移灶的有效方法,治疗后~(131)I显像是判断其疗效的可靠方法。
Objective To analyze the imaging characteristics, clinical efficacy and influential factors of high dose 131I treatment of pulmonary metastases in differentiated thyroid cancer. Methods A total of 156 patients with differentiated thyroid cancer were treated with high dose 131I, of which 12 cases had metastases in the lung (subtotal or total thyroidectomy and cervical lymph node dissection). ~ (131) I single dose of 2.22 ~ 7.4GBq, total dose of 7.4GBq ~ 33.3GBq. Follow-up duration of at least one year. Efficacy of the determination: chest X-ray and / or CT examination, ~ (131) I imaging, serum thyroglobulin and thyroglobulin antibody levels, but mainly 131I imaging. Results Of the 12 patients, 11 had intrapulmonary metastases in ~ (131) I imaging after treatment, of which 9 showed 131I uptake in the lung after the first treatment and 2 in the second treatment Showed 131I uptake in the lung, and another patient did not show 131I uptake in the lung metastases after treatment. Of the 11 patients who showed ~ (131) I uptake in the lung, no abnormality was found in 6 cases of X-ray or CT examination. After 131I treatment, all the patients had different degrees of improvement after high dose of 131I treatment. 131I I imaging in the lung decreased gradually after 131I I treatment, and finally showed normal in 3 patients after treatment. Conclusion ~ (131) I is an effective method for the treatment of metastatic pulmonary metastases in differentiated thyroid cancer. ~ 131 I imaging is a reliable method to evaluate its efficacy.