新疆医科大学学报

目的 探究SPECT/CT融合显像在分化型甲状腺癌患者接受放射性核素¹³¹Ⅰ治疗中的应用价值。方法 选取2024年1月至2025年1月期间在本院行放射性核素¹³¹Ⅰ治疗的120例分化型甲状腺癌(DTC)患者作为研究对象，所有患者均接受放射性核素¹³¹Ⅰ治疗。受试者根据影像学检查方式分为两组,对照组患者使用SPECT成像技术进行定位诊断，研究组患者使用SPECT/CT融合显像技术进行定位诊断。比较两组病灶定位准确率、残留率及转移率的差异，并采用χ²检验、Logistic回归模型及ROC曲线评价SPECT与SPECT/CT的诊断效能。结果 SPECT组与SPECT/CT组之间原发病灶、TSH、Tg、¹³¹Ⅰ剂量相比，差异有统计学意义(P<0.05),多因素Logistic回归分析结果显示，原发病灶、TSH、Tg、¹³¹Ⅰ剂量均为分化型甲状腺癌的危险因素(P<0.05)。与SPECT组相比，SPECT/CT组病灶定位准确率更高，治疗后其病灶组织残留率和癌细胞远处转移率均更低，差异有统计学意义(P<0.05)。SPECT显像诊断灵敏度为97.62%,准确度为83.33%,特异度50.00%。SPECT/CT融合显像诊断灵敏度为96.15%,准确度为90.00%,特异度50.00%。SPECT/CT融合显像诊断效能优于SPECT显像诊断(P<0.05)。结论 SPECT/CT融合显像在DTC患者放射性核素¹³¹Ⅰ治疗中具有显著的应用价值，可以为临床医生提供全面、准确的诊断依据，有助于提高治疗效果。

Objective To explore the application value of SPECT/CT fusion imaging in the treatment of differentiated thyroid cancer(DTC) patients with radioactive isotope ¹³¹Ⅰ. Methods 120 DTC patients treated with radioactive isotope ¹³¹Ⅰ in the hospital from January 2024 to January 2025 were selected as study subjects, and all patients received radioactive isotope ¹³¹Ⅰ treatment. Subjects were divided into two groups according to the imaging modality used: patients in the control group underwent localization diagnosis with SPECT imaging, whereas those in the study group received SPECT/CT fusion imaging for localization diagnosis. Differences in lesion-localization accuracy, residual tissue rate and metastasis rate between the 2 groups were compared using χ² test. Logistic regression and ROC analyses were employed to evaluate the diagnostic performance of SPECT versus SPECT/CT. Results Significant differences in primary lesion size, TSH, Tg, and ¹³¹Ⅰ dose were observed between the SPECT and SPECT/CT groups(P<0.05). Multivariate Logistic regression identified primary lesion size, TSH, Tg, and ¹³¹Ⅰ dose as independent risk factors for differentiated thyroid carcinoma(P<0.05). Compared with the SPECT group, patients in the SPECT/CT group demonstrated significantly higher accuracy in lesion localization, lower post-treatment residual tissue rates, and reduced cancer cell metastasis rates, with all differences being statistically significant(P<0.05). The diagnostic sensitivity of SPECT imaging was 97.62%, the accuracy was 83.33%, and the specificity was 50.00%. The sensitivity, accuracy and specificity of SPECT/CT fusion imaging diagnosis were 96.15%, 90.00% and 50.00%, respectively. The diagnostic efficacy of SPECT/CT fusion imaging was superior to that of SPECT imaging(P<0.05). Conclusion SPECT/CT fusion imaging has significant application value in the treatment of DTC patients with radioactive isotope ¹³¹Ⅰ, which can provide comprehensive and accurate diagnostic basis for clinical doctors and help improve treatment effectiveness.