亚急性甲状腺炎的核医学检查应用研究——附145例分析

Scintiscaning in the diagnosis of subacute thyroiditis:a report of 145cases.

目的:探讨用于诊断亚急性甲状腺炎(亚甲炎)的核医学检查方法的应用时机与价值。方法:对145例初诊亚甲炎的99mTc甲状腺γ显像结果进行总结,并与同期甲状腺131I摄取率(RAIU)、血清总三碘甲状腺原氨酸(TT3)、总甲状腺素(TT4)的关系进行对比分析;同时对27例的核医学随访结果进行分析。结果:145例亚甲炎初诊时甲状腺双叶弥漫性肿大多见,单叶肿大次之,单叶局部结节最少;其99mTc甲状腺γ显像结果全部异常。99mTc甲状腺γ显像结果与RAIU结果之间有良好的相关关系;与TT3、TT4水平增高之间有良好的负相关关系,但甲状腺肿大与99mTc甲状腺γ显像结果并非完全一致,不一致率为35.2%。结论:对初诊的亚甲炎病人应选99mTc甲状腺γ显像或RAIU作为确诊指标,同时测定TT3、TT4、甲状腺球蛋白抗体(TGA)、甲状腺微粒体抗体(TMA)水平;长期随访宜选择TT3、TT4、促甲状腺激素、TGA、TMA作为观察指标。

Objective:To study the timing and the value of scintiscaning in the diagnosis of subacute thyroiditis.Methods:99m Tc-thyroid scintiscaning,131 I-uptake rate(RAIU)were performed and serum triiodothyronine (T 3 ),thyroxine (T 4 )levels were mea-sured in145patients with subacute thyroiditis.Their relationships were analyzed,and the results of nuclear imaging were followed up in27cases.Results:Bilateral diffuse goiter was the most common sign in the initial visit,followed by single lobe enlargement.Uni lateral lo calized nodule was rare.Abnormal 99m Tc-thyroid scintiscaning was seen in all145cases.Close relationship between 99m Tc-thyroid imaging and RAIU,and negative correlation between 99m Tc-thyroid imaging and T 3 ,T 4 levels were fo und.However,the sign of goiter was not well matched with the results of 99m Tc-thyroid imaging (with discordance rate of35.2%).Conclusion:For mak ing a correct diagnosis of subacute thyroiditis,99m Tc-thyroid scintiscaning or RAIU should be the first choice of nuclear examination,and T 3 ,T 4 ,thyroglob ulin an tibod ies(TGA)and thyroid microsomal antibodies(TMA)should also be determined at the first visit of patients.T 3 ,T 4 ,thyroid-stim ulating hormone,TGA and TMA can all serve as indexes for follow-up.