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201铊闪烁扫描术在分化型甲状腺癌中的应用:与放射性碘闪烁扫描术及血清甲状腺球蛋白测定的比较

Thallium-201 scintigraphy in differentiated thyroid cancer: comparison with radioiodine scintigraphy and serum thyroglobulin determinations.

作者信息

Ramanna L, Waxman A, Braunstein G

机构信息

Department of Nuclear Medicine, Cedars-Sinai Medical Center, Los Angeles, California 90048.

出版信息

J Nucl Med. 1991 Mar;32(3):441-6.

PMID:2005453
Abstract

The role of thallium-201 (201TI) scintigraphy in the follow-up evaluation of differentiated thyroid carcinoma (DTC) is controversial. Desirable characteristics of 201TI scintigraphy including the potential for no thyroid hormone withdrawal, immediate imaging postinjection, and low radiation burden relative to iodine-131 (131I) suggests it is logistically superior to 131I scintigraphy. Fifty-two patients with DTC were evaluated with 201TI and 131I neck and chest images, and serum thyroglobulin measurements. In post-thyroidectomy and pre-131I ablation therapy patients, very little 201TI accumulation was noted within the thyroid bed, with discordantly increased 131I activity and normal serum thyroglobulin measurements. Twenty-nine percent of patients evaluated after 131I ablative therapy had elevated serum thyroglobulin levels and localized neck and chest abnormalities on 201TI scan that were not seen on 131I studies. Our data suggest that 201TI is more sensitive than 131I diagnostic (5 mCi) studies for detection of DTC, while 131I is more sensitive in detecting normal residual thyroid tissue postoperatively.

摘要

铊-201(201TI)闪烁扫描术在分化型甲状腺癌(DTC)随访评估中的作用存在争议。201TI闪烁扫描术的理想特性包括无需停用甲状腺激素、注射后可立即成像以及相对于碘-131(131I)辐射负担较低,这表明其在操作上优于131I闪烁扫描术。对52例DTC患者进行了201TI和131I颈部及胸部成像以及血清甲状腺球蛋白测量。在甲状腺切除术后及131I消融治疗前的患者中,甲状腺床内几乎未发现201TI积聚,而131I活性却异常增加,血清甲状腺球蛋白测量结果正常。在131I消融治疗后接受评估的患者中,29%的患者血清甲状腺球蛋白水平升高,且201TI扫描显示颈部和胸部有局部异常,而131I检查未发现这些异常。我们的数据表明,对于检测DTC,201TI比131I诊断性(5毫居里)检查更敏感,而131I在检测术后正常残留甲状腺组织方面更敏感。

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