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【medical-news】髓样甲状腺癌转移的影像学检测策
After extensive surgery, calcitonin levels plummet in most patients with medullary thyroid carcinoma (MTC) without lymph node metastases. Calcitonin, however, remains elevated in two-thirds of patients who have lymph node involvement, and this is an accepted marker for persistent disease. Multiple imaging procedures are performed to detect the metastases, but many examinations prove negative. Since recurrences occur in many patients within 5 years, current imaging techniques obviously have limited sensitivity.
Imaging techniques with increased reproducibility are now required to assess recently developed treatments. A large number of techniques are available, but no consensus exists on their selective use in patients with MTC. To rectify this, Giraudet et al. prospectively studied 55 consecutive patients who had MTC and persistently elevated calcitonin levels, using neck and abdomen ultrasonography, neck, chest and abdomen spiral CT, liver MRI and whole body MRI, bone scintigraphy and fluorodeoxyglucose-PET plus CT (PET–CT).
Ultrasonography was the most sensitive technique for detecting neck recurrence. Lung metastases were detected most accurately by CT, and mediastinum lymph node metastases were detected most accurately by PET–CT. MRI liver imaging proved to be the most sensitive technique for detecting liver metastases. Bone scintigraphy and MRI revealed bone metastases equally well and were both superior to PET–CT.
The authors conclude that the most efficient imaging work-up for depicting MTC recurrence or metastasis consists of neck ultrasonography, chest CT, liver MRI, bone scintigraphy and axial skeleton MRI.
http://www.nature.com/ncpendmet/journal/v4/n1/full/ncpendmet0690.html 本人认领此文编译. 如48小时内未能提交译文, 其他战友自由认领. Imaging-based detection of metastases in patients with medullary thyroid carcinoma甲状腺髓样癌转移的影像学检测策略
After extensive surgery, calcitonin levels plummet in most patients with medullary thyroid carcinoma (MTC) without lymph node metastases. Calcitonin, however, remains elevated in two-thirds of patients who have lymph node involvement, and this is an accepted marker for persistent disease. Multiple imaging procedures are performed to detect the metastases, but many examinations prove negative. Since recurrences occur in many patients within 5 years, current imaging techniques obviously have limited sensitivity.
甲状腺髓样癌(MTC)患者在甲状腺全切术后，大多数无淋巴结转移者降钙素水平直线下降，但三分之二伴淋巴结转移的患者降钙素水平升高，这也是疾病持续的一个公认指标。很多影像检查用来检测转移灶，但大多不能令人满意（or大多结果阴性？个人比较倾向前者）。由于许多病人在5年内复发，目前的影像学检测技术灵敏度极其有限。
Imaging techniques with increased reproducibility are now required to assess recently developed treatments. A large number of techniques are available, but no consensus exists on their selective use in patients with MTC. To rectify this, Giraudet et al. prospectively studied 55 consecutive patients who had MTC and persistently elevated calcitonin levels, using neck and abdomen ultrasonography, neck, chest and abdomen spiral CT, liver MRI and whole body MRI, bone scintigraphy and fluorodeoxyglucose-PET plus CT (PET–CT).
目前亟需再现性较高的成影像技术，经评估最新的治疗方法。现存的大量技术是否能选择性用于MTC患者，尚未达成共识。为改善这种状况，Giraudet等人应用颈部及腹部超声检查，颈部、胸部及腹部螺旋CT检查，肝脏及全身MRI，骨闪烁显像及氟脱氧葡萄糖-PET加CT (PET–CT)检查，前瞻性研究了55例降钙素水平持续增高的MTC患者。
Ultrasonography was the most sensitive technique for detecting neck recurrence. Lung metastases were detected most accurately by CT, and mediastinum lymph node metastases were detected most accurately by PET–CT. MRI liver imaging proved to be the most sensitive technique for detecting liver metastases. Bone scintigraphy and MRI revealed bone metastases equally well and were both superior to PET–CT.
超声检查对于检测颈部复发最敏感。肺转移检测最准确的是CT ，纵隔淋巴结转移检测最准确的PET–CT。肝脏MRI被证明是检测肝转移最敏感的技术。检测骨转移时，骨闪烁显像与MRI同样准确，且均优于PET–CT。
The authors conclude that the most efficient imaging work-up for depicting MTC recurrence or metastasis consists of neck ultrasonography, chest CT, liver MRI, bone scintigraphy and axial skeleton MRI.
作者总结，检测MTC复发或转移最有效的影像检查包括颈部超声、胸部CT、肝脏MRI、骨骼闪烁显像及中轴骨骼MRI。
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作者:admin@医学,生命科学 2011-02-15 17:11
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