Sürücü Erdem, Bekiş Recep, Sengöz Tarık, Demir Yusuf, Celik Ahmet Orhan, Orbay Ozge, Birlik Bilge, Ozdoğan Ozhan, Iğci Enis, Durak Hatice
Yüzüncü Yıl University School of Medicine, Department of Nuclear Medicine, Van, Turkey.
Dokuz Eylül University School of Medicine, Department of Nuclear Medicine, İzmir, Turkey.
Mol Imaging Radionucl Ther. 2013 Dec;22(3):85-9. doi: 10.4274/Mirt.24119. Epub 2013 Dec 10.
The radiation can induce vessel injury. The result of this injury can be severe and life-threatening. There are a few studies demonstrating an increase in intima-media thickness (IMT) of the common carotid artery (CCA) after radiotherapy, especially in head and neck cancers. We evaluated the effect of I-131 to the IMT of the CCA in the patients who were treated for hyperthyroidism.
38 patients (25M, 13W) referred to our department for radioiodine treatment with the diagnosis of nodular goitre (25 patients) and diffuse hyperplasia (Graves disease (GD), 13 patients) were included to the prospective study. An USG was performed for all the patients before therapy, 3, 6 and 12 months after radioiodine therapy in order to measure IMT of CCA and the femoral artery (FA). The IMT was measured at the level of proximal part of bulbus anteriorly on the left and right side. The IMT of FA was measured just before the bifurcation.
There was a statistically significant increase in IMT of both CCA and FA bilaterally in nodular hyperthyroid patients. However, in the patients with Graves disease, there was only statistically significant increase in the left IMT of CCA at 0-3rd, 0-6th month measurements and in the right IMT of FA at 0-3rd month measurements.
Though the limitation of the study is the interobserver and intraobserver variability, it was seen that I-131 therapy might affect the IMT of CCA in the patients with NG. I-131 effect on the IMT of CCA in patients with nodular goitre was higher than the IMT of CCA in patients with GD. I-131 effect on the IMT of CCA might be due to administered dose and adjacency. The interesting point of our study was the increased thickness of IMT in FA. We think that the increase in IMT is due to the systemic effect of radioactivity circulating in the blood vessel. I-131 effect on the IMT of FA in patients with nodular goitre was higher than the IMT of FA in the patients with GD due to I-131 uptake of thyroid gland. Because I-131 uptake was lower in patients with nodular goitre, I-131 in systemic circulation was higher.
None declared.
辐射可导致血管损伤。这种损伤的后果可能很严重甚至危及生命。有一些研究表明放疗后颈总动脉（CCA）的内膜中层厚度（IMT）增加，尤其是在头颈部癌症患者中。我们评估了I-131对接受甲状腺功能亢进治疗患者CCA的IMT的影响。
38例患者（25例男性，13例女性）因结节性甲状腺肿（25例）和弥漫性增生（格雷夫斯病（GD），13例）被转诊至我科接受放射性碘治疗，纳入前瞻性研究。在治疗前、放射性碘治疗后3、6和12个月对所有患者进行超声检查，以测量CCA和股动脉（FA）的IMT。在左右侧球部近端水平测量IMT。在分叉前测量FA的IMT。
结节性甲状腺功能亢进患者双侧CCA和FA的IMT均有统计学显著增加。然而，在格雷夫斯病患者中，仅在0至3个月、0至6个月测量时左侧CCA的IMT以及在0至3个月测量时右侧FA的IMT有统计学显著增加。
尽管该研究的局限性在于观察者间和观察者内的变异性，但可以看出I-131治疗可能会影响NG患者的CCA的IMT。I-131对结节性甲状腺肿患者CCA的IMT的影响高于GD患者CCA的IMT。I-131对CCA的IMT的影响可能归因于给药剂量和毗邻关系。我们研究的有趣之处在于FA的IMT厚度增加。我们认为IMT的增加是由于血管中循环的放射性的全身效应。由于甲状腺对I-131的摄取，I-131对结节性甲状腺肿患者FA的IMT的影响高于GD患者FA的IMT。因为结节性甲状腺肿患者的I-131摄取较低，全身循环中的I-131较高。
未声明。
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