甲状腺摄^(99m)TC率在桥本氏甲状腺疾病中的应用价值

Clinical Value of ^(99m)TC Uptake Rate Determination in Diagnosis of Hashimoto′s Disease

目的 :探讨甲状腺摄99mTC率 ,在桥本氏甲状腺疾病中的应用价值。方法 :在作甲状腺99mTC显像时 ,测定甲状腺99mTC率 ,并与甲状腺血清学指标比较。结果 :桥本氏甲亢或甲减 ,甲状腺外形均显示增大 ,放射性分布不均匀 ,前者摄锝功能增强 ,摄锝率为 6 0 7± 4 6 9,与对照组比较 ,差异有显著性 (p <0 0 5 ) ;后者 ,17 2 % (5 2 9)伴有“凉结节”或“冷结节” ,摄锝功能增高或正常 ,摄锝率为 1 6 9± 1 0 0 ;与对照组比较 ,差异无显著性 (p >0 0 5 )。结论 :甲状腺99mTC显像 ,并计算甲状腺摄99mTC率 ,能准确反映甲状腺的位置、大小、形态、甲状腺包块的摄取情况及甲状腺摄取功能 ,结合甲状腺血清学指标 ,在桥本氏甲状腺疾病中的诊断、鉴别。

Objective To explore the clinical value of 99m TC uptake rate determination for diagnosis of Hashimoto's disease. Methods 99m TC thyroid imaging was performed on 21 patients with HT hyperthyroidism, 29 patients with HT hypothyroidism and 97 controls. 99m TC uptake rate was calculated. Serum thyroid hormones (FT 3, FT 4, TSH) and antibodies (TGA, TPO-AB) were determined in all these subjects with CLIA and RIA respectively. Results Thyroid imaging revealed swelling of the gland and arymmetrical distribution of radioactivity in both the hyper and hypo-thyroidism patients. 99m TC uptake rate was increased in the hyperthyroid group (6 07±4 69), being significantly higher than that in controls ( p <0 05). Howerer, the uptake rate in hypothyroid group (1 69±1 00%) was not much different from that of the controls. A cool or cold nodule was observed in 17 2% (5/29) of the hypothyroid patients. Conclusion 99m TC thyroid imaging and uptaket rate determination can accurately reveal the size, shape and condition of radioactivity distribution of the gland as well as presence of any nodule. Combined with serum thyroid hormones and antibodies measurement, the 99m TC study can be of great importance in the diagnosis and management of Hashimoto′s disease.