目的治疗剂量131ISPECT/CT在评 价分化型甲状腺癌(DTC)局部淋巴结转移 中的价值。方法 回顾性分析我院2016年 1月-2017年12月收治的100例分化型甲状 腺癌患者临床资料。应用SPECT/CT、多 层螺旋CT扫描检查。结果 131I-WBS结果： 300例患者中有110例患者为单纯甲状腺 残留，转移95例，完全去除20例。阳性病 灶共680枚，残留病灶330枚，转移病灶 350枚，其中颈部或纵隔淋巴结转移140 枚，远处转移210枚。SPECT/CT断层融合 显像结果：300例患者经SPECT/CT诊断后 发现，单纯甲状腺残留有120例患者，转 移病例有104例，共有712枚阳性病灶，甲 状腺残留病灶378枚，转移病灶410枚，其 中颈部或纵隔淋巴结转移160枚，远处转 移250枚。患者有淋巴结转移者，通常是 在131I治疗后随访观察淋巴结有无缩小、 增大或者消失，如有复发者，才行穿刺活 检继而手术治疗。二合并肺、骨等远处转 移者，SPECT-CT都是阳性，即可确诊， 无需手术病理。SPECT/CT诊断DTC转移病 灶灵敏度、特异性、准确性显著高于131IWBI(P<0.05)。SPECT/CT淋巴结数、远处 转移、淋巴结检出率、远处转移检出率显 著高于131I-WBI(P<0.05)。结论 SPECT/CT 能显著提高分化型甲状腺癌局部淋巴结转 移诊断率，值得推荐使用。

Objective To investigate the clinical value of radioiodine 131I ablation with SPECT/CT fusion imaging for evaluating lymph node metastasis in differentiated thyroid cancer (DTC). Methods The clinical data of 100 patients with DTC who were admitted to our hospital from January 2016 to December 2017 were retrospectively analyzed, all patients underwent the SPECT/CT fusion imaging and CT examination. Results The 131I-WBI showed that of the 300 patients, 110 patients had simple thyroid residuals, 95 had metastases, and 20 had been completely removed. There were 680 positive lesions including 330 residual lesions, and 350 metastatic lesions, of which 140 lymph nodes metastasis from the neck or mediastinum, and 210 cases of distant metastasis. The SPECT/ CT fusion imaging showed that the there were 120 patients with residual thyroid alone and 104 cases with metastatic disease. There were 712 positive lesions, 378 residual thyroid lesions, and 410 metastatic lesions, of which 160 were cervical or mediastinal lymph node metastases and 250 distant metastases. The surgical results showed that there were 110 cases of simple thyroid residue, 104 cases of metastasis, 398 residual lesions and 413 metastatic lesions, of which 152 were cervical or mediastinal lymph node metastasis and 261 were distant metastasis. The sensitivity, specificity and accuracy of SPECT/CT in diagnosing DTC metastases were significantly higher than those in 131I-WBI (P<0.05). The detection rate of lymph node and distant metastasis in SPECT/CT was significantly higher than that of 131I-WBI (P<0.05). Conclusion SPECT/CT can significantly improve the diagnostic rate of regional lymph node metastasis in differentiated thyroid cancer and is worth recommending.