Casara D, Rubello D, Saladini G
Department of Radiotherapy and Nuclear Medicine, General Hospital of Padua, Italy.
Biomed Pharmacother. 2000 Jul;54(6):334-6. doi: 10.1016/S0753-3322(00)80059-1.
The commonly used procedure for the diagnosis of thyroid nodule malignancy is based on high resolution thyroid ultrasonography (US) combined with US-guided fine needle aspiration cytology (FNAC). The other imaging procedures have a limited role in malignancy diagnosis. However, nuclear medicine procedures, particularly scintigraphy with tumor-seeking agents such as 201-thallium (201-TI), 99mTc-methoxy-isobutyl-isonitrile (99mTc-MIBI) and 99mTc-tetrofosmin may play an important role in the differential diagnosis between benign and malignant thyroid nodules in cases of non-diagnostic or inadequate FNAC. This type of scintigraphy can also be used in the follow-up of patients with cytologically 'high'-risk thyroid nodules such as Hurtle cell adenomas and follicular adenomas. Furthermore, scans with tumor-seeking agents can be helpful in determining the preoperative staging of thyroid carcinoma patients with locally advanced disease, and in accurately evaluating the extent, and consequently, the surgical management of the disease.
诊断甲状腺结节恶性病变的常用方法是基于高分辨率甲状腺超声（US）联合超声引导下细针穿刺细胞学检查（FNAC）。其他成像检查在恶性病变诊断中的作用有限。然而，核医学检查，特别是使用如201铊（201-TI）、99m锝-甲氧基异丁基异腈（99mTc-MIBI）和99m锝-替曲膦等亲肿瘤剂的闪烁扫描，在FNAC诊断不明确或不充分的情况下，可能在甲状腺良恶性结节的鉴别诊断中发挥重要作用。这种类型的闪烁扫描还可用于对细胞学检查为“高”风险甲状腺结节（如Hurthle细胞腺瘤和滤泡性腺瘤）患者的随访。此外，使用亲肿瘤剂的扫描有助于确定局部晚期甲状腺癌患者的术前分期，并准确评估疾病范围，从而确定手术治疗方案。
