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(18)F-氟脱氧葡萄糖正电子发射断层扫描所识别的局灶性和弥漫性甲状腺疾病的临床意义

Clinical significance of focal and diffuse thyroid diseases identified by (18)F-fluorodeoxyglucose positron emission tomography.

作者信息

Salvatori M, Melis L, Castaldi P, Maussier M L, Rufini V, Perotti G, Rubello D

机构信息

Institute of Nuclear Medicine, Università Cattolica del S. Cuore, Rome, Italy.

出版信息

Biomed Pharmacother. 2007 Sep;61(8):488-93. doi: 10.1016/j.biopha.2007.05.001. Epub 2007 Jun 13.

Abstract

(18)F-Fluorodeoxyglucose positron emission tomography (FDG-PET) thyroid incidentalomas are defined abnormal FDG uptake in the thyroid gland found at PET scan performed as part of a staging protocol and follow-up of patients with various kinds of malignancies. In the present study we report two cases of FDG PET thyroid incidentalomas, and review the literature with regard to the meaning of this new category of thyroid "disease". Since the advent of whole body FDG PET scan, a relatively high incidence of cases of thyroid FDG uptake has been reported as an incidental finding as in one of our patient. Focal uptake was found to be more likely associated to a malignant lesion, while a diffuse thyroid uptake to a benign thyroid disease. However, differential diagnosis is difficult, and reported data in literature are somewhat discordant. A focal thyroid uptake of FDG incidentally discovered at PET scan cannot be invariably considered a malignant thyroid nodule, however a prompt and complete work-up including laboratory examinations, ultrasonography and fine needle aspiration cytology, should be obtained to exclude a thyroid carcinoma. On the other hand, patients with a PET finding of diffuse FDG uptake can be considered at low risk of malignancy, being more likely associated to chronic thyroiditis or diffuse thyroid autonomy.

摘要

(18)氟脱氧葡萄糖正电子发射断层扫描(FDG-PET)甲状腺偶发瘤是指在作为各种恶性肿瘤患者分期方案和随访一部分而进行的PET扫描中发现甲状腺内FDG摄取异常。在本研究中,我们报告了2例FDG PET甲状腺偶发瘤病例,并就这一新型甲状腺“疾病”的意义对文献进行了综述。自从全身FDG PET扫描问世以来,甲状腺FDG摄取病例作为偶发发现的发生率相对较高,就像我们的一位患者那样。发现局灶性摄取更可能与恶性病变相关,而弥漫性甲状腺摄取则与良性甲状腺疾病相关。然而,鉴别诊断困难,文献报道的数据也有些不一致。在PET扫描中偶然发现的甲状腺FDG局灶性摄取不能一概被视为恶性甲状腺结节,不过应进行包括实验室检查、超声检查和细针穿刺细胞学检查在内的快速全面检查,以排除甲状腺癌。另一方面,PET发现弥漫性FDG摄取的患者可被视为恶性风险较低,更可能与慢性甲状腺炎或弥漫性甲状腺自主性相关。

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