Université Paris Descartes and Assistance Publique-Hôpitaux de Paris, Department of Nuclear Medicine, Cochin Hospital, 27 rue du Faubourg Saint Jacques, 75679 Paris Cedex 14, France.
Best Pract Res Clin Endocrinol Metab. 2014 Mar;28(2):203-20. doi: 10.1016/j.beem.2013.04.011. Epub 2013 May 28.
Color Doppler Ultrasounds (CDU) and Thyroid Scanning (TS) have much improved in recent years and offer a likely diagnosis of the disorder and its main subtypes. This especially applies when diagnosing permanent or transient causes of congenital hypothyroidism (CH), where dual imaging has proven to be more informative than single scanning. Though both isotopes have acceptable performances, the use of (123)I appears more advisable, since it more accurately identifies the various aetiologies of CH and probably has better dosimetric characteristics than (99m)Tc. Detailed dual imaging patterns are presented in connection with most of the underlying mechanisms explaining CH, thyroid dysgenesis (75%) and dyshormonogenesis (20%). Imaging of thyroid autoimmunity, of immunogenic thyrotoxicosis and of thyroid autonomy, is helped by CDU but most often requires a quantified (123)I-TS (molecular imaging). We finally show the interest of CDU to sort suspicious nodule and present the new TIRADS scoring system.
近年来,彩色多普勒超声(CDU)和甲状腺扫描(TS)有了很大的改进,为该疾病及其主要亚型的诊断提供了可能。当诊断先天性甲状腺功能减退症(CH)的永久性或暂时性原因时,这尤其适用,双影像检查已被证明比单一扫描更具信息量。尽管两种同位素都有可接受的性能,但使用 (123)I 似乎更可取,因为它更准确地识别 CH 的各种病因,并且可能比 (99m)Tc 具有更好的剂量特性。详细的双影像模式与解释 CH、甲状腺发育不全(75%)和激素生成障碍(20%)的大多数潜在机制相关联。CDU 有助于甲状腺自身免疫、免疫性甲状腺毒症和甲状腺自主性的成像,但大多数情况下需要定量 (123)I-TS(分子成像)。我们最后展示了 CDU 对可疑结节进行分类的兴趣,并介绍了新的 TIRADS 评分系统。