Hiromatsu Yuji, Ishibashi Masatoshi, Nishida Hidemi, Kawamura Seiji, Kaku Hiroo, Baba Kenkichi, Kaida Hayato, Miyake Ikuyo
Department of Endocrinology and Metabolism, Kurume University School of Medicine, Kurume, Fukuoka, 830-0011, Japan.
Endocr J. 2003 Jun;50(3):239-44. doi: 10.1507/endocrj.50.239.
To determine if subacute thyroiditis (SAT) is associated with changes in the regional perfusion of the thyroid gland, we performed Tc-99 m sestamibi scans on eleven patients with SAT who had painful goiter and clinical thyrotoxicosis. Eleven patients had Tc-99 m pertechnetate and Tc-99 m sestamibi scintigraphy during the acute stage of SAT. The thyroid uptake ratio of sestamibi was compared with the laboratory data and color Doppler ultrasonography. Tc-99 m pertechnetate scintigraphy in the thyroid was markedly reduced during the acute stage of SAT. Conversely, Tc-99 m sestamibi showed diffuse increased uptake in the thyroid region, suggesting increased perfusion. On the other hand, there was near absence of vascularization in the acute phase and slight increase in the recovery phase by color Doppler ultrasonography. The clearance rate of Tc-99 m sestamibi during the early phase (from 10 min to 1 h) was decreased in the acute stage of SAT. The sestamibi uptake ratio correlated with serum immunosuppressive acidic protein (IAP) in the acute stage of SAT and the sestamibi uptake ratio in the recovery stage of SAT was correlated with serum thyrotropin levels. Tc-99 m sestamibi uptake in the early phase in the acute stage of SAT may reflect the inflammatory process associated with SAT.
为了确定亚急性甲状腺炎（SAT）是否与甲状腺局部灌注的变化有关，我们对11例患有疼痛性甲状腺肿和临床甲状腺毒症的SAT患者进行了锝-99m甲氧基异丁基异腈（Tc-99m sestamibi）扫描。11例患者在SAT急性期进行了高锝酸盐（Tc-99m pertechnetate）和Tc-99m sestamibi闪烁扫描。将sestamibi的甲状腺摄取率与实验室数据及彩色多普勒超声检查结果进行比较。在SAT急性期，甲状腺的Tc-99m高锝酸盐闪烁扫描明显降低。相反，Tc-99m sestamibi显示甲状腺区域摄取弥漫性增加，提示灌注增加。另一方面，彩色多普勒超声检查显示急性期甲状腺几乎无血管化，恢复期略有增加。在SAT急性期，早期（10分钟至1小时）Tc-99m sestamibi的清除率降低。SAT急性期sestamibi摄取率与血清免疫抑制酸性蛋白（IAP）相关，SAT恢复期sestamibi摄取率与血清促甲状腺激素水平相关。SAT急性期早期的Tc-99m sestamibi摄取可能反映了与SAT相关的炎症过程。
