Piga M, Cocco M C, Serra A, Boi F, Loy M, Mariotti S
Nuclear Medicine, Department of Medical Sciences M. Aresu, University of Cagliari, Cagliari, Italy.
Eur J Endocrinol. 2008 Oct;159(4):423-9. doi: 10.1530/EJE-08-0348. Epub 2008 Jul 4.
Amiodarone-induced thyrotoxicosis (AIT) is caused by excessive hormone synthesis and release (AIT I) or a destructive process (AIT II). This differentiation has important therapeutic implications.
To evaluate (99m)Tc-sestaMIBI (MIBI) thyroid scintigraphy in addition to other diagnostic tools in the diagnosis and management of AIT.
Thyroid and (99m)Tc-MIBI scintigraphies were performed in 20 consecutive AIT patients, along with a series of biochemical and instrumental investigations (measurement of thyrotrophin, free thyroid hormones and thyroid autoantibodies; thyroid colour-flow Doppler sonography (CFDS) and thyroid radioiodine uptake (RAIU)).
On the basis of instrumental and laboratory data (excluding thyroid (99m)Tc-MIBI scintigraphy) and follow-up, AIT patients could be subdivided into six with AIT I, ten with AIT II and four with indefinite forms of AIT (AIT Ind). (99m)Tc-MIBI uptake results were normal/increased in all the six patients with AIT I and absent in all the ten patients with AIT II. The remaining four patients with AIT Ind showed low, patchy and persistent uptake in two cases and in the other two evident MIBI uptake followed by a rapid washout. MIBI scintigraphy was superior to all other diagnostic tools, including CFDS (suggestive of AIT I in three patients with AIT II and of AIT II in three with AIT Ind) and RAIU, which was measurable in all patients with AIT I, and also in four out of the ten with AIT II.
Thyroid MIBI scintigraphy may be proposed as an easy and highly effective tool for the differential diagnosis of different forms of AIT.
胺碘酮所致甲状腺毒症（AIT）是由激素过度合成与释放（AIT I型）或破坏性过程（AIT II型）引起的。这种区分具有重要的治疗意义。
评估（99m）锝-甲氧基异丁基异腈（MIBI）甲状腺闪烁扫描术以及其他诊断工具在AIT诊断和管理中的作用。
对20例连续的AIT患者进行甲状腺及（99m）Tc-MIBI闪烁扫描，同时进行一系列生化和仪器检查（促甲状腺激素、游离甲状腺激素和甲状腺自身抗体测定；甲状腺彩色多普勒超声（CFDS）和甲状腺放射性碘摄取（RAIU））。
根据仪器和实验室数据（不包括甲状腺（99m）Tc-MIBI闪烁扫描）及随访情况，AIT患者可分为6例AIT I型患者、10例AIT II型患者和4例AIT不确定型（AIT Ind）患者。6例AIT I型患者的（99m）Tc-MIBI摄取结果正常/增加，10例AIT II型患者均无摄取。其余4例AIT Ind患者中，2例显示摄取低、呈斑片状且持续，另外2例MIBI摄取明显但随后迅速洗脱。MIBI闪烁扫描术优于所有其他诊断工具，包括CFDS（在3例AIT II型患者中提示为AIT I型，在3例AIT Ind患者中提示为AIT II型）和RAIU，所有AIT I型患者及10例AIT II型患者中的4例可测量RAIU。
甲状腺MIBI闪烁扫描术可作为一种简便且高效的工具，用于不同类型AIT的鉴别诊断。
