Hamburger J I, Hamburger S W
J Nucl Med. 1985 Aug;26(8):888-92.
Toxic multinodular goiters, estimated weight 100 g or more, occurred in 35 patients between 1961 and 1984. All but two were older than 50; 32 were females. Twenty had goiters of 100-130 g; four of 140-200 g; and 11 were massive. Radioiodine uptakes were 30% or less for 22. Seven of 17 with both T4 and T3 data had T4 toxicosis. Thirty-two patients received radioiodine therapy, delivering 200 microCi per gram when possible. Doses were 25-30 mCi for 17 patients; 50-100 mCi for 12 patients, and 150-200 mCi for three patients. Hyperthyroidism was eliminated with one dose in 25 patients (78%); five patients required two doses. Twenty-two patients were euthyroid after radioiodine; 25 of 28 had persistent goiters. Two patients were treated successfully surgically. One refused surgery and radioiodine, and has been maintained on antithyroid drugs for 10 yr. Two patients died within a few months of an unsuccessful initial dose of radioiodine. Large dose radioiodine therapy is simple, safe, and effective for most patients with large toxic multinodular goiters.
1961年至1984年间，35例患者出现毒性多结节性甲状腺肿，估计重量为100克或更重。除2例患者外，其余均年龄超过50岁；32例为女性。20例甲状腺肿重量为100 - 130克；4例为140 - 200克；11例为巨大甲状腺肿。22例患者的放射性碘摄取率为30%或更低。在17例同时有T4和T3数据的患者中，7例有T4中毒。32例患者接受了放射性碘治疗，尽可能每克给予200微居里。17例患者的剂量为25 - 30毫居里；12例患者为50 - 100毫居里；3例患者为150 - 200毫居里。25例患者（78%）一剂消除了甲状腺功能亢进；5例患者需要两剂。放射性碘治疗后22例患者甲状腺功能正常；28例中有25例甲状腺肿持续存在。2例患者手术治疗成功。1例患者拒绝手术和放射性碘治疗，服用抗甲状腺药物已维持10年。2例患者在首次放射性碘剂量治疗失败后的几个月内死亡。大剂量放射性碘治疗对大多数巨大毒性多结节性甲状腺肿患者简单、安全且有效。
