诊断剂量131I对分化型甲状腺癌摄131I功能影响的定量研究

Quantitive Study about Influence of 131I Diagnostic Dose on Uptake of 131I for Differentiated Thyroid Carcinoma

  • 摘要: 分析131I治疗的52例分化型甲状腺癌术后患者,30例试验组患者手术后和131I治疗前均口服131I,诊断剂量为74 MBq,并行诊断性全身显像和治疗性全身显像,两次显像的残余甲状腺组织或功能性转移灶的放射性计数分别以DxTx表示。22例对照组患者术后直接给予131I治疗,并行治疗性全身显像。结果表明,试验组患者Tx显著小于Dx和对照组患者Tx,根据服用诊断性131I到131I治疗的时间间隔为1~2 d、3~7 d和8~32 d,试验组患者分为A、B、C组, A组、C组患者的Tx/Dx值显著大于B组,A组和C组患者的Tx/Dx差异无统计学意义。以上结果表明,74 MBq诊断剂量131I可产生“顿抑效应”,且“顿抑效应”在服用诊断剂量131I后3~7 d更明显。

     

    Abstract: There are 52 patients with DTC who were referred to our department for radioiodine ablation for the first time were adopted. 30 patients (experimental group) were given a diagnostic scan (Dscan) 24 hours after the administration of 74 MBq 131I before radioiodine therapy, and a therapeutic scan (Tscan) was performed after radioiodine therapy. The fractional concentrations of 131I in remnants or functional metastases were quantified on Dscan and Tscan, and were expressed as Dx and Tx respectively. 22 patients (control group) received 131I therapy directly after thyroidectomy. And Tscan was performed after the radioiodine ablation. As a result the mean Tx(experimental group) was lower both than Dx(experimental group) and Tx(control group). According to the interval time between the diagnostic dose and therapy dose was 1.2, 3.7 and 832 days, the experimental group patients were divided into three subgroups A、B、C. The mean Tx/Dx of subgroup B was lower than Tx/Dx of subgroups A and C. There was no statistically significant difference of Tx/Dx between subgroup A and C. In conclusions that 74 MBq 131I for diagnostic scan can cause thyroid stunning. And the stunning effect is more significant when the radioiodine ablation was performed on 3 to 7 days after diagnostic dose.

     

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