目的 了解分化型甲状腺癌患者131Ⅰ治疗后全身显像(Rx-WBS)盆腔131Ⅰ明显浓聚情况及可能机制.方法 ①回顾性收集168例分化型甲状腺癌女性患者的资料(均有Rx-WBS图像).②分析Rx-WBS图像特点,根据一定的纳入标准,最终纳入分析46例患者,并进行随访.结果 盆腔131Ⅰ明显浓聚的46例(46处浓聚)患者中,6例同时存在2个可能的浓聚原因,2例目前浓聚原因不明.在50个导致盆腔131Ⅰ浓聚的原因中,与子宫相关41个,与子宫外相关9个,分别为直肠3个、膀胱5个、卵巢巧克力囊肿1个.在41个与子宫相关的浓聚因素中,结合SPECT/CT定位、B超、CT及随访结果发现,子宫肌瘤18个、节育器9个、子宫内膜增厚2个、宫腔积液3个、月经期7个、子宫内膜腺肌症1个、孕囊1个.结论 ①当女性甲状腺癌患者的Rx-WBS图像在盆腔子宫水平出现131Ⅰ明显浓聚时,多与子宫相关,膀胱因素相对少见;当浓聚定位到子宫时,排除生理性摄取,多提示相关的妇科疾病,以子宫肌瘤多见.②膀胱、直肠所致的盆腔子宫水平131Ⅰ明显浓聚有其自身特点,相对易区分.③SPECT/CT对定位子宫浓聚131Ⅰ具有重要意义.%Objective To analyze and explore the possible mechanism for pelvic 131Ⅰ uptake after 131Ⅰ post treatment whole body scan (RX-WBS)in patients with differentiated thyroid cancer.Methods ①Data were retrospectively reviewed from 168 female patients with differentiated thyroid cancer(everyone has a RX-WBS).②46 patients were accepted by analyzing the characteristics of RxWBS and combing with some inclusion criteria,and then followed up.Results Among the 46 patients (46 positions accumulated 131Ⅰ)with significant pelvic 131Ⅰ uptake,6 patients had two reasons leading to pelvic 131Ⅰ uptake,and 2 patients had no specific reason.Among the 50 reasons for pelvic 131Ⅰ uptake,41 reasons related with uterus,3 reasons related to rectum,5 related to bladder and 1 related to ovarian chocolate cyst.Among the 41 reasons related to uterus,by combining the examinations of SPECT/CT,ultrasound,CT and the follow-up results,18 were uterine leiomyomas,9 were intrauterine devices,2 were endometrial thickening,3 were uterine cavity effusion,7 were menstrual periods,1 were uterine adenomyosis,1 were gestational sac.Conclusions (①In the Rx-WBS of female,the significant pelvic 131Ⅰ uptake is generally caused by uterus,but not bladder.And it usually means gynecological disease,especially uterine leiomyomas when excluding physiological factors.②It is generally easy to differentiate bladder from rectum because they have different characteristic features of the pelvic 131Ⅰ uptake.(③SPECT/CT plays a very important role in locating 131Ⅰ uptake in uterus.
展开▼
