目的：探讨18 F-FDG PET／CT在甲状腺乳头状癌全切术后131 I治疗后、131 I全身显像阴中的价值。方法回顾性分析2007年～2015年14例甲状腺乳头状癌术后、131 I治疗后、131 I全身显像阴性伴或不伴甲状腺球蛋白，怀疑复发或转移的患者PET／CT检查资料，根据摄取程度分为良性或恶性，所有病变最终有病理确认或经随访证实。结果14例甲状腺乳头状癌中，发生在左叶4例，右叶8例，双叶2例。18 F-FDG PET／CT显像提示术区及全身阴性5例，术区和／或淋巴结异常摄取9例，其中真阳性7例。转移部位分别为：双侧颌下、右颈部、右锁骨上1例；右颌下、左颈部、双肺1例；右锁骨上、右口咽旁1例；左颈部、气管左旁、胸1～4椎体1例；气管右旁1例；右颌下、左颈部、左鼻咽旁1例；左颈部、左锁骨上、右锁骨上1例；1例局部复发并远处转移。 SUVmax最大值39．6，SUVmax最小值3．1，平均SUVmax 11.12±8．57。 Tg升高患者8例，其中Tg最大值为1398．0ug／L，TG最小值为117．0ug／L，平均值为（377．31±488．89）ug／L，1例TgAb升高大于500IU／L，TG为1．38 ug／L。 SUVmax与Tg之间线性相关性分析，相关系数R2＝0．495，自变量系数为0．012。结论当131 I全身显像阴性、血清甲状腺球蛋白增高大于32．7ug／L时，18 F-FDG PET／CT显像则能发现转移或复发灶，优于131 I全身显像。而131 I全身显像阴性时、血清Tg小于3．9ug／L时，18 F-FDG PET／CT显像并不能提供更多的诊断价值。%Objective The aim of this study was to investigate the clinical value of 18 F-FDG PET/CT in patients with total thyroidectomy followed by negative iodine whole-body scan .Methods From 2007 to 2015 , PET/CT data of 14 cases of papillary thyroid carcinoma (PTC) after operation, after the treatment with 131I, and negative 131I whole body imaging, suspected recurrent or metastatic patients , were retrospectively analyzed .According to the degree of uptake , they were divided into benign or malig-nant lesions, all lesions confirmed by pathology or follow-up.Results 4 cases of PTC located in the left lobe of the thyroid gland , 8 cases in the right lobe , and 2 cases in the bilateral thyroid gland .18 F-FDG PET/CT imaging showed the surgical site and whole body negative results in 5 cases, the operation area and/or lymph node of abnormal uptake in 9 cases.7 were true positive. The metastatic sites were as follow bilateral submandibular space , right cervical lymph nodes , and the right supraclavicular lymph nodes in 1 case respectively;right submandibular space , left cervical lymph nodes, right supraclavicular lymph nodes , both lung, and right parapharyngeal space in 1 case respectively;the left cervical lymph nodes , paratracheal lymph nodes , and thoracic ver-tebral 1~4 involved in 1 case respectively;the right submaxillary lymph node , the left neck lymph node , and the left side of the nasopharynx lymph node in 1 case respectively;the left neck, Left supraclavicular , right supraclavicular recurrence and metasta-ses was in 1 case respectively.The maximum SUV was 39.6, the minimum SUV was 3.1, and an average SUV was 1.12.Tg in-creased in 8 cases, of which the maximum value of Tg was 1398.0 ug/L, the minimum value of Tg was 117.0 ug/L, the average value was (377.31 ±488.89) ug/L, 1 case of TgAb increased more than 500 IU/L, while its Tg was in normal range.Linear correlation was analyzed between SUVmax and Tg , the correlation coefficient square was 0.495 and the coefficient of the variables was 0.012.Conclusion The serum thyroglobulin was greater than 32.7 ug/L, and negative for 131 I whole body imaging, metas-tases or recurrence can be detected by 18F-FDG PET/CT imaging, better than 131I whole body imaging.When the serum Tg was less than 3.9 ug/L, 131 I whole body imaging negative , 18 F-FDG PET/CT imaging could not provide more diagnostic value .
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