[先天性甲状腺功能减退症新生儿的锝99m-高锝酸盐甲状腺闪烁扫描术]
[Tc99m-pertechnetate thyroid scintigraphy in newborns with congenital hypothyroidism].
作者信息
Lobo Gabriel, Ladrón de Guevara David, Arnello Francisca, Pérez Andrés, Vivanco Ximena, Bruggendieck Bernardo, Bustos María Eliana, Jiménez César, Donoso Gilda, Brantes Jorge, Becerra Carlos
机构信息
Unidad de Medicina Nuclear, CDT Hospital San Juan de Dios, Servicio de Pediatría, Hospital San Juan de Dios, Servicio de Salud Metropolitano Occidente, Ministerio de Salud, Chile.
出版信息
Rev Med Chil. 2003 Mar;131(3):283-9.
BACKGROUND
Congenital hypothyroidism is one of the most frequent endocrine diseases of the newborn and requires an early diagnosis to avoid its deleterious effects on neurological and intellectual functions.
AIM
To evaluate thyroid scintigraphy (TS) findings in newborns with congenital hypothyroidism (CH), detected in the national program of newborn screening, which is working in Chile since 1992.
MATERIAL AND METHODS
TS findings of 189 newborns with CH (68% female) were analyzed. Tc99m pertechnetate TS was performed at 19 +/- 11 days of life. The gland was classified as eutopic, ectopic or absence of contrast (AC). Eutopic glands were classified by visual and quantitative criteria as: normal, goiter and decreased contrast (DC). TS results were compared by gender and hormonal levels.
RESULTS
Forty seven percent of newborns had ectopy, 29.1% eutopy and 24.3% AC. Eutopic gland predominated in males (44.2% vs 22.7%) and ectopy was more frequent in girls (53.1% vs 32.8%, p < 0.05). Newborns with AC had the most severe hormonal alterations, without gender differences. Newborns with normal TS had less hormonal alterations than those with goiter.
CONCLUSIONS
TS allows an etiological classification of CH. Thyroid dysgenesis is the most frequent cause, most of which correspond to ectopy, especially in girls. Eutopic glands are present in one third of newborns with CH. Goiter predominates, especially in males.
背景
先天性甲状腺功能减退症是新生儿中最常见的内分泌疾病之一，需要早期诊断以避免其对神经和智力功能的有害影响。
目的
评估在智利自1992年起开展的全国新生儿筛查项目中检测出的先天性甲状腺功能减退症（CH）新生儿的甲状腺闪烁显像（TS）结果。
材料与方法
分析了189例CH新生儿（68%为女性）的TS结果。在出生后19±±11天进行高锝[Tc99m]酸盐TS检查。甲状腺被分类为正常位置、异位或无造影剂（AC）。正常位置的甲状腺根据视觉和定量标准分类为：正常、甲状腺肿和造影剂减少（DC）。按性别和激素水平比较TS结果。
结果
47%的新生儿有异位，29.1%为正常位置，24.3%为AC。正常位置的甲状腺在男性中占主导（44.2%对22.7%），异位在女孩中更常见（53.1%对32.8%，p<0.05）。AC的新生儿激素改变最严重，无性别差异。TS正常的新生儿激素改变比甲状腺肿的新生儿少。
结论
TS可对CH进行病因分类。甲状腺发育不全是最常见的原因，其中大部分为异位，尤其是在女孩中。三分之一的CH新生儿有正常位置的甲状腺。甲状腺肿占主导，尤其是在男性中。
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