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自主性甲状腺结节显像诊断分析 |
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高硕 吴晓琪 贾强 张富海
【摘要】 目的 评价99mTc、99mTc-MIBI(甲氧基异丁基异腈)核素显像、B超在自主性甲状腺结节(AFTN)诊断中的应用。方法 31例患者男9例，女22例，年龄15～87岁。全部病例均完成血清FT3、FT4、TSH的测定，并进行了B超甲状腺检查、99mTc以及99mTc-MIBI甲状腺显像。结果 31例患者中，28例99mTc显像表现为单发“热”结节，3例为多发“热”结节，“热”结节周围的甲状腺组织不显像者共10例，显像较差者21例。99mTc-MIBI甲状腺显像结果为，17例“热”结节外原显像较差或不显像的甲状腺组织均获得一定程度改善，另14例未见明显变化。在伴有典型甲亢症状的13例中，FT3及FT4均高于正常值上限、TSH低于正常值下限的9例。另4例表现为T3型甲亢。在甲亢症状不典型的18例中，2例诊断为T3型甲亢，4例为亚临床甲亢；其余12例甲状腺功能正常。结论 99mTc-MIBI甲状腺显像可以代替TSH刺激显像或甲状腺抑制显像而用于AFTN的临床诊断。
【关键词】 自主功能性甲状腺结节 甲状腺激素 超声 放射性核素显像 诊断
Evaluation of different diagnostic approaches for autonomously functioning thyroid nodule
GAO Shuo,WU Xiaoqi,JIA Qiang,et al.Department of Nuclear Medicine,General Hospital of Tianjin Medical University,Tianjin,300052
【Abstract】 Objective To evaluate 99mTc, 99mTc-MIBI imaging scintigraphy, ultrasonic (US) scan, in the assessment of the autonomously functioning thyroid nodule (AFTN). Methods 31 patients with thyroid nodule (s), 9 males and 22 females, aged from 15 to 87 years, were investigated with US scan, 99mTc and 99mTc-MIBI imaging, FT3、FT4 and TSH measurement. Results Of 31 cases investigated, 28 cases were shown with solitary hot nodule and 3 cases with multiple ones by 99mTc imaging. The extranodular thyroid tissue was totally suppressed in 10 cases and partially suppressed in 21 cases. By 99mTc-MIBI thyroid imaging, the suppressed tissue became clearer in 17 and no change in 14 as compared with their 99mTc imaging. Of the 13 cases with clinical thyrotoxicosis, 9 cases were found with serum FT3 and FT4 values above normal and serum TSH values below normal, the rest 4 with increased FT3, normal FT4 and decreased TSH. Among the 18 asymptomatic patients, 2 were found with thyrotoxicosis (high FT3, normal FT4 and low TSH), 4 with subclinical thyrotoxicosis, the rest with normal FT3, FT4 and TSH values. Conclusion 99mTc-MIBI thyroid imaging is a promisi[1] [2] 下一页
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